Claims Edit Specialist I

June 11, 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="https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html" 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 This job is responsible for reviewing and processing basic insurance claim edits in a timely manner under direct supervision of supervisor. <ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l1 level1 lfo1;tab-stops:list .5in;">Shift - 8-hour, flex shift Monday through Friday</li><li class="MsoNormal" style="mso-list:l1 level1 lfo1;tab-stops:list .5in;">Work From Home: Although this is a WFH position, the applicant must live in the Greater DFW area. </li></ul>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 membersJob Expectations:<ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l2 level1 lfo2;tab-stops:list .5in;">Work both independently and collaboratively within a team to achieve production goals and deadlines.</li><li class="MsoNormal" style="mso-list:l2 level1 lfo2;tab-stops:list .5in;">Demonstrate a strong commitment to productivity by staying focused and on task without constant supervision.</li><li class="MsoNormal" style="mso-list:l2 level1 lfo2;tab-stops:list .5in;">Effectively communicate with colleagues, supervisors, and managers to ensure clarity, alignment, and successful outcomes.</li><li class="MsoNormal" style="mso-list:l2 level1 lfo2;tab-stops:list .5in;">Take ownership of assigned tasks and projects, demonstrating accountability and reliability in meeting expectations.</li><li class="MsoNormal" style="mso-list:l2 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="MsoNormal" style="mso-list:l2 level1 lfo2;tab-stops:list .5in;">Proactively identify opportunities for process improvement and contribute innovative solutions to enhance overall productivity and teamwork</li></ul>Hard Skills<ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Epic experience</li><li class="MsoNormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Knowledge and experience with registration</li><li class="MsoNormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Knowledge and experience with health insurance carriers</li><li class="MsoNormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Ability to read and understand Explanation of Benefits</li><li class="MsoNormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Ability to multitask</li><li class="MsoNormal" style="mso-list:l3 level1 lfo3;tab-stops:list .5in;">Contacting insurance companies and patients</li></ul>Soft Skills<ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Outlook experience</li><li class="MsoNormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Team experience</li><li class="MsoNormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Excel experience</li><li class="MsoNormal" style="mso-list:l0 level1 lfo4;tab-stops:list .5in;">Medical Terminology </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="http://jobs.utsouthwestern.edu/benefits/#top" 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 equivalent </li></ul><ul><li>Experience 2 years of experience with medical billing or claims processing, knowledge of billing and/or collections rules and regulations May consider education in lieu of experience. </li></ul> JOB DUTIES<ul><li>Reviews and processes basic insurance claim edits through the billing system for registration and demographic accuracy.</li><li>Utilizes vendor and third party websites for eligibility and benefit verification, including update of registration information within the billing system.</li><li>Reposts and resubmits claims based on research findings and billing system updates.</li><li>Works in all professional billing service areas.</li><li>Updates registration and demographic information in at least two hospital billing service areas.</li><li>Escalates issues above knowledge base to higher level specialist or supervisor.</li><li>Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human-subjects research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.</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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