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Technical Denials Management Specialist III

June 5, 2026

WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to <a href="" target="_blank">U.S. News & World Report</a>, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARY UT Southwestern Medical Center has a new opportunity available in the Revenue Cycle Department for the role of Technical Denials management Specialist II. You will review, research and resolve claim denials and appeals for various insurance companies while identifying payment trends to maximize collections. The ideal candidate is well versed in working with EPIC Resolute. <ul style="margin-top:0in;" type="disc"><li class="xxmsonormal" style="mso-list:l2 level1 lfo1;tab-stops:list .5in;">Shift: Flex start 0600-0900, 8-hour shift</li><li class="xxmsonormal" style="mso-list:l2 level1 lfo1;tab-stops:list .5in;">Work From Home (WFH): This is a WFH position. Applicants must live within the Greater DFW area. </li></ul><a href=" Southwestern Medical Center has a new opportunity available in the Revenue Cycle Department team for the role of Technical Denials management Specialist II. Our Culture: Our teams culture is Love Based, which thrives on mutual respect, empathy, and support, fostering an environment where every member feels valued and empowered. It prioritizes open communication, collaboration, and understanding, creating a cohesive and inclusive community where individuals can flourish personally and professionally. Love Based cultivates a culture where kindness, compassion, and appreciation are foundational principles, leading to greater creativity, productivity, and fulfillment for all team members. Job Expectations: Work both independently and collaboratively within a team to achieve production goals and deadlines. Demonstrate a strong commitment to productivity by staying focused and on task without constant supervision. Effectively communicate with colleagues, supervisors, and manager to ensure clarity, alignment, and successful outcomes. Take ownership of assigned tasks and projects, demonstrating accountability and reliability in meeting expectations. Adapt to changing priorities and work demands while maintaining a high level of quality and efficiency. Proactively identify opportunities for process improvement and contribute innovative solutions to enhance overall productivity and teamwork Ability to contact medical insurance payer and resolve outstanding claims Ability to appeal denied claim and overturn the denial. Hard Skills Experience with Reconsideration, Redeterminatio" target="_blank">Our Culture:</a>The team culture is Love Based, which thrives on mutual respect, empathy, and support, fostering an environment where every member feels valued and empowered. It prioritizes open communication, collaboration, and understanding, creating a cohesive and inclusive community where individuals can flourish personally and professionally. Love Based cultivates a culture where kindness, compassion, and appreciation are foundational principles, leading to greater creativity, productivity, and fulfillment for all team members. <a href=" Expectations:" target="_blank">Job Expectations:</a><ul style="margin-top:0in;" type="disc"><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Work both independently and collaboratively within a team to achieve production goals and deadlines.</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Demonstrate a strong commitment to productivity by staying focused and on task without constant supervision.</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Effectively communicate with colleagues, supervisors, and manager to ensure clarity, alignment, and successful outcomes.</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Take ownership of assigned tasks and projects, demonstrating accountability and reliability in meeting expectations.</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Adapt to changing priorities and work demands while maintaining a high level of quality and efficiency.</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Proactively identify opportunities for process improvement and contribute innovative solutions to enhance overall productivity and teamwork</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Ability to contact medical insurance payer and resolve outstanding claims</li><li class="xxmsonormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Ability to appeal denied claim and overturn the denial.</li></ul><a href=" Skills" target="_blank">Hard Skills </a><ul style="margin-top:0in;" type="disc"><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Experience with Reconsideration, Redetermination, and Appeal with health insurance carriers.</li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Knowledge and experience with handling and resolving NCCI edits, LCD/NCD, and bundling denials. </li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Knowledge and experience with denial codes from the remittance/EOB </li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Knowledge and experience with contacting health insurance carriers</li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Ability to read and understand Explanation of Benefits</li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Ability to multitask Contacting insurance companies and patients</li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Knowledge and experience with online payer portals</li><li class="xxmsonormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Epic experience with reviewing medical records </li></ul><a href=" Skills" target="_blank">Soft Skills</a><ul style="margin-top:0in;" type="disc"><li class="xxmsonormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Outlook experience</li><li class="xxmsonormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Outlook Teams App experience</li><li class="xxmsonormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Excel experience</li><li class="xxmsonormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Medical Terminology</li><li class="xxmsonormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Payer Portal experience </li></ul>BENEFITS UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:<ul><li>PPO medical plan, available day one at no cost for full-time employee-only coverage</li><li>100%25 coverage for preventive healthcare-no copay</li><li>Paid Time Off, available day one</li><li>Retirement Programs through the Teacher Retirement System of Texas (TRS)</li><li>Paid Parental Leave Benefit</li><li>Wellness programs</li><li>Tuition Reimbursement</li><li>Public Service Loan Forgiveness (PSLF) Qualified Employer</li><li><a href="" target="_blank">Learn more about these and other UTSW employee benefits!</a></li></ul> EXPERIENCE AND EDUCATION Required<ul><li>Education High School Diploma or Associate's Degree </li></ul><ul><li>Experience 4 years experience in medical claims recovery and/or collections with High School Diploma. or 2 years experience in medical claims recovery and/or collections within a healthcare or insurance environment is preferred with Associates Degree. </li></ul> JOB DUTIES<ul><li>Contact payers, via website, phone and/or correspondence, regarding reimbursement of unpaid accounts over thirty (30) days or more, also researching and following up on denials and request for additional information.</li><li>Interpret Manage Care contracts and/or Medicare and Medicaid rules and regulations to ensure proper reimbursement/collection.</li><li>Make necessary adjustments as required by plan reimbursement.</li><li>Perform payment validation by utilizing internal and/or external resources to ensure proper reimbursement.</li><li>Review, research and appeal partially denied claims for reconsideration.</li><li>Responsible for contacting patients to gain additional information required to resolve outstanding insurance balances.</li><li>Function as resource person for departmental personnel to answer questions and assist with problem resolution.</li><li>Review and resolve provider NPI/TPI claim edits rejections.</li><li>Review and resolve provider NPI/TPI claim denial.</li><li>Assist with working Claim Edit Work queues.</li><li>Assist with working Team Lead Work queues.</li><li>Assist with New Hire Training.</li><li>Performs other duties as assigned.</li></ul>SECURITY AND EEO STATEMENT Security This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

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Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

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Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...