Revenue Cycle Representative

UNC REX Healthcare; Eastowne (NC); Remote; USD 10,000 - 60,000; Full time

Job summary

Join a leading healthcare organization as a Claims Processor, where you'll manage insurance claims, ensure compliance, and promote teamwork. The role requires attention to detail and good communication skills, alongside at least 2 years of experience in insurance processes.

Qualifications

• At least 2 years in hospital or physician insurance activities.
• Knowledge of health insurance processes is essential.

Responsibilities

• Ensure accurate and timely submission of claims.
• Manage insurance follow-up and collections.

Skills

Attention to detail

Good communication skills

Education

High School Degree

Job description

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the communities we serve.

Summary:

This role involves performing complex duties related to insurance claims, including managing claims with no response from payors, handling claim edits, and addressing claim denials. The position requires maintaining acceptable accounts receivable levels through prompt follow-up on unpaid and denied claims, reviewing credit balances for reallocation or refunds, and posting payments, contractual adjustments, and denials accurately and timely. The role also includes processing paper correspondence and promoting teamwork in alignment with UNC Health’s mission and philosophy.

Responsibilities:

• Ensure the accurate and timely submission of claims, respond to denials, and re-bill insurance claims.
• Manage insurance follow-up and collections by resolving discrepancies via charge corrections, payment corrections, write-offs, refunds, or other methods.
• Edit claims within scope or escalate as needed to meet billing compliance guidelines for electronic submission.
• Contact insurance carriers for authorizations and referrals, and research medical records to substantiate procedures.
• Analyze and correct patient invoices or accounts to ensure clean claim submissions or re-bills.
• Maintain work queues, review third-party correspondence, and resolve issues related to payments, denials, secondary billing, credit balances, and non-payment.
• Communicate with patients, physicians, and insurance companies to resolve account issues through adjustments, refunds, or write-offs.
• Verify claims adjudication, post payments and denials, and reconcile accounts accurately.
• Respond to correspondence professionally and promptly, identify trends, and suggest resolutions to management.
• Maintain understanding of health insurance policies and procedures, document collection activities, and participate in training to develop job knowledge.

Meet or exceed productivity and quality standards.

Other Information

• Education Requirements: High School Degree
• Experience Requirements: At least 2 years in hospital or physician insurance activities such as authorization, billing, follow-up, call-center, or collections.
• Knowledge/Skills: Knowledge of health insurance processes, good communication skills, attention to detail, and ability to work independently and as part of a team.

Job Details

• Employer: NCHEALTH
• Entity: Shared Services
• Organization Unit: Physician Ins Billing and Foll
• Type: Full Time
• Hours: 40 per week
• Salary Range: $17.94 - $25.25 per hour
• Work Location: Remote, in Chapel Hill, NC
• Work Schedule: Day Job
• Employment Type: Exempt from Overtime

This position is employed by NC Health, a subsidiary of UNC Health Care System. Qualified applicants will be considered regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Reasonable accommodations are available upon request.