Revenue Cycle Financial Representative

UNC Health; Chapel Hill (NC); Remote; USD 26,000 - 37,000; Full time

Benefits offered by this job

Remote work option

Job summary

UNC Health is seeking a financial counselor to perform pre-service estimates, collection of pre-payments, and patient billing education across hospital and physician services. You will handle Medicaid eligibility screening, payment plans, and inquiries from patients via calls, MyUNCChart, and walk-ins.

The role requires strong communication, knowledge of UB-04 and EOB interpretation, and the ability to manage complex billing workflows in a fast-paced healthcare setting.

Qualifications

• Two years of hospital or physician insurance-related or call center CS experience.
• Excellent interpersonal, verbal and written communication skills.
• Advanced knowledge of UB-04, HCFA-1500s and EOB interpretation.
• Intermediate knowledge of CPT and ICD-9 codes.
• Knowledge of insurance billing, collections and terminology.
• Proficient in MS Word, Excel and Outlook.

Responsibilities

• Create hospital and physician estimates using Epic Patient Estimator and review eligibility.
• Provide benefit education and secure payment or set expectations at service.
• Generate estimates for patient shoppers and clinical areas; assist with templates.
• Train clinical areas on estimates and collections scripting; monitor accuracy.
• Follow up on Medicaid and financial assistance approvals; handle inquiries via multiple channels.
• Itemize charges, add billing and establish payment plans; explain charity policy.
• Outreach on delinquent plans; manage high-risk accounts and disputed debt.
• Collaborate with Patient Relations and Risk Management on escalated cases.

Skills

Interpersonal skills

Verbal communication

Written communication

Listening skills

Organizational skills

Customer service

MS Word

Excel

Outlook

Education

High school diploma or GED

Tools

UB-04

HCFA-1500s

EOB interpretation

CPT codes

ICD-9 codes

Job description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary:
Responsible for performing a variety of complex pre-services, financial counseling and customer service related functions for patients and/or their representative including pre-service estimates, collection of pre-payments, collection of prior debt, obtaining authorizations, addressing billing questions, establishing payment plans, screening for financial assistance, responding to MyUNCChart inquiries and other Customer Service requests for both hospital and physician services.

Responsibilities

• 1. Create Hospital and Physician estimates using the Epic Patient Estimator, review eligibility and benefits utilizing RTE, and obtain authorization requirements.
• 2. Contact patient pre-service providing benefit and patient liability education, explain the estimate cost, and attempt to secure payment and/or set expectation of payment at time of service.
• 3. Provide estimates to patient shoppers and clinical areas across the healthcare system. Work with clinical areas to create estimate templates, determine workflow and process, and collaborate with ISD for template creation and rollout. Provide payment plans for point-of-service (POS) collections.
• 4. Train clinical areas on estimate usage and patient scripting for collections, audit and provide feedback on accuracy of estimates utilizing Epic estimate reports. Track and trend collection amounts and template accuracy utilizing hospital and physician EOBs and refine process to enhance accuracy. Screen and assist patients with financial assistance, Medicaid eligibility and/or other funding sources available.
• 5. Monitor and track routine follow up with Medicaid and financial assistance approvals. Handles HB/PB patient inquiries to address any/all billing questions via inbound calls, MyUNCChart, patient correspondence and patient walk-ins.
• 6. Fulfills patient requests for itemization of charges, adding/verifying/billing insurance, establishing payment plans, payroll deductions, process adjustments, request refunds, and explain charity care policy and guidelines.
• 7. Initiate patient outreach on delinquent payment plans, adding accounts to existing payment plans and high risk/balance accounts. Investigate HB and PB Set off Debt Collection Act (SODCA) disputed accounts that have received a NC State Income Tax refund withhold using current and legacy billing and imaging systems. Meets with attorneys to record depositions, collaborate with the attorney general’s office and attend/participate in hearings when needed.
• 8. Work with Patient Relations, Risk Management for HB and PB patients who have escalated complaints or concerns. Oversee HB Client account billing and follow-up which includes validating charges and fee schedules, review and move charges, research and reconcile payments, communicate with multiple departments to answer client questions and collect payments. Work with external customers such as collection agencies, clinics to address any patient concerns

Other Information

Other information:
Education Requirements:
High school diploma or GED required; higher-level degree may satisfy this requirement.
Licensure/Certification Requirements:
No licensure or certification required.
Professional Experience Requirements:
Two (2) years of experience in Hospital or Physician Insurance related activities or Call Center Customer Service experience. (Authorization, Billing, Follow-Up, Call-Center, or Collections).
Knowledge/Skills/and Abilities Requirements:
Excellent interpersonal, verbal and written communication skills.
Excellent listening skills, and organizational skills.
Advanced knowledge of UB-04, HCFA-1500’s and Explanation of Benefits (EOB) interpretation.
Intermediate knowledge of CPT and ICD-9 codes.
Advanced knowledge of insurance billing, collections and insurance terminology.
Ability to work in fast pace environment and prioritize and manage multiple tasks.
Healthcare terminology.
Customer Service skills.
Computer knowledge: MS Word, Excel, and Outlook.
Knowledge of 3rd party reimbursements from insurance companies and government payers is a plus.

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: PFE Coverage Coordination

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range:$19.12 - $27.17 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: No

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.