Senior Revenue Cycle Specialist - Pre-Service & RTE

Sigma Gamma Rho Sorority, Inc; Chapel Hill (NC); Remote; USD 28.000 - 39.000; Vollzeit

Zusammenfassung

UNC Health in Chapel Hill, NC is seeking a Senior Revenue Cycle Representative to support pre-service and post-service activities, with a focus on advanced insurance verification and Real-Time Eligibility (RTE). You will mentor staff, develop training materials, conduct quality audits, and lead workflow improvement and automation initiatives in a remote work setting offering a 40-hour work week.

Qualified candidates have at least three years in hospital/physician insurance operations and

Qualifikationen

• Three years of experience in Hospital or Physician Insurance activities.
• Experience with Epic eligibility workflows and coverage verification preferred.
• Experience training, onboarding, mentoring staff preferred.
• Advanced knowledge of insurance verification and benefit interpretation.
• Proficiency in MS Office applications.

Aufgaben

• Perform advanced insurance coverage verification and benefit investigation.
• Investigate and troubleshoot complex eligibility and Real-Time Eligibility issues.
• Identify recurring payer, benefit, workflow, or system-related trends.
• Serve as a SME for coverage verification workflows and payer requirements.
• Conduct quality audits to evaluate documentation accuracy and verification quality.
• Provide feedback and coaching based on quality reviews.
• Assist with onboarding, training, and mentoring newly hired Revenue Cycle Representatives.
• Develop and maintain training materials, tip sheets, SOPs, and workflow documents.
• Monitor quality trends and identify opportunities for process improvement.
• Escalate high-impact payer and eligibility issues to leadership.
• Participate in workflow redesign, process improvement, reporting, and automation initiatives.
• Support departmental projects and implementation of new verification workflows.

Kenntnisse

Insurance verification

Benefit interpretation

MS Office

Analytical/problem solving

Process improvement

Training/coaching

Ausbildung

High school diploma or GED

Tools

Epic

Jobbeschreibung

UNC Health in Chapel Hill, NC is seeking a Senior Revenue Cycle Representative to support pre-service and post-service activities, with a focus on advanced insurance verification and Real-Time Eligibility (RTE). You will mentor staff, develop training materials, conduct quality audits, and lead workflow improvement and automation initiatives in a remote work setting offering a 40-hour work week.

Qualified candidates have at least three years in hospital/physician insurance operations and