Revenue Cycle Claims & Denials Specialist

UNC Health; Chapel Hill (NC); Hybride; CAD 35 000 - 50 000; Plein temps

Résumé du poste

UNC Health Care in Chapel Hill, NC, seeks an Authorization Denials Specialist to perform complex duties in insurance follow-up, denial resolutions, and post-claim work. The role emphasizes accurate, timely submissions, appeals, and coordination with internal/external departments to resolve discrepancies and optimize aging A/R.

Reports to the Authorization Denials Supervisor and works in a hybrid setting. Responsibilities include processing follow-up and reconsiderations, researching medical

Qualifications

• Two (2) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections).
• Knowledge of insurance guidelines surrounding authorizations and referrals is preferred.
• Ability to analyze invoices and respond to denials and corrections with accuracy.

Responsabilités

• Submit claims follow up, reconsiderations, and appeals; respond to denials; re-bill insurance claims.
• Research medical records to support medical justification for procedures and submit necessary information to carriers.
• Maintain work queues; review third-party correspondence; navigate payer systems for authorizations and retro authorizations.
• Read and interpret EOBs; document collection activity; participate in meetings and trainings.

Connaissances

Authorization

Billing

Follow-Up

Call Center

Collections

Formation

High School Degree

Description du poste

UNC Health Care in Chapel Hill, NC, seeks an Authorization Denials Specialist to perform complex duties in insurance follow-up, denial resolutions, and post-claim work. The role emphasizes accurate, timely submissions, appeals, and coordination with internal/external departments to resolve discrepancies and optimize aging A/R.

Reports to the Authorization Denials Supervisor and works in a hybrid setting. Responsibilities include processing follow-up and reconsiderations, researching medical