Revenue Cycle Representative

UNC Health; North Carolina; Remoto; USD 25.000 - 35.000; Tempo pieno

Descrizione del lavoro

UNC Health in Chapel Hill, NC, seeks a detail-oriented Billing Specialist to manage insurance claims follow-up, denials, and patient accounts. You will coordinate with carriers, verify adjudication, post payments, and maintain aging targets while ensuring compliance with billing guidelines.

This full-time remote role supports UNC Health's shared services across North Carolina, offering predictable hours and collaboration with multidisciplinary teams to improve cash flow and patient service.

Competenze

• Two (2) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections)
• High School Degree required
• Experience with insurance follow-up and collections processes is preferred

Mansioni

• Responsible for the accurate and timely submission of claims, response to denials, and re-bills of insurance claims.
• Responsible for all aspects of insurance follow-up and collections including interfacing with internal and external departments to resolve discrepancies.
• Post payments and denials to patient invoices/accounts in a timely and accurate manner.
• Reconcile accounts and respond to correspondence to resolve issues related to posting of payments and charges.

Formazione

High School Degree

Descrizione del lavoro

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.

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

May be responsible for performing a variety of complex duties, including but not limited to, working outstanding insurance claims having no response from payors, having claim edits, and/or having received claim form related denials. Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims and denied claims. Review credit balances for possible reallocation or refunds. May be responsible for posting payments, contractual adjustments, and denials in a timely, accurate, and complete manner. Process paper correspondence as assigned. Performs all duties in a manner which promotes teamwork and reflects UNC Health's mission and philosophy.

Responsibilities

• Responsible for the accurate and timely submission of claims, response to denials, and re-bills of insurance claims. Responsible for all aspects of insurance follow-up and collections including interfacing with internal and external departments to resolve discrepancies through charge corrections, payment corrections, writeoffs, refunds or other methods. Edit claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority (or elevate as needed) to meet and satisfy billing compliance guidelines for electronic submission. Contact insurance carriers to obtain authorizations and referral approvals for services and procedures. Research medical records to gather information and substantiate medical justification for procedures as required by insurance carriers. Submits requested medical information to insurance carrier.
• Responsible for the analysis and necessary corrections of patient invoices or accounts as it pertains to clean claim submissions or re-bills. Responsible for maintaining work queues. Access, review and respond to third party correspondence via Document Management system. Research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, credit balances, sequencing of charges, and non-payment of claims. Contact patients, physicians and insurance companies to obtain information necessary for invoice or account resolution through write-offs, reversals, adjustments, refunds or other methods. Verify claims adjudication utilizing appropriate resources and applications. Post payments (Insurance and/or Patient) and denials to patient invoices/accounts in a timely and accurate manner.
• Reconcile accounts, research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, sequencing of charges, and non-payment of claims. Respond to any assigned correspondence in a timely, professional, and complete manner. Identify issues and/or trends and provide suggestions for resolution to management, including payer, system or escalated account issues. May maintain data tables for systems that support Patient Accounting operations. Evaluate carrier and departmental information and determines data to be included in system tables. Read and interpret EOB's (Explanation of Benefits).
• Maintain basic understanding and knowledge of health insurance plans, policies and procedures. Accurately and thoroughly document the pertinent collection activity performed. Participate and attend meetings, training seminars and in-services to develop job knowledge. Meets/Exceeds Productivity and Quality standards

Other Information

Other information:

Education Requirements

• High School Degree

Professional Experience Requirements

• Two (2) years of experience in hospital or physician insurance related activities ((Authorization, Billing, Follow-Up, Call-Center, or Collections)

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: $18.12 - $25.51 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.