Senior Revenue Cycle Specialist: Real-Time Eligibility

UNC Health; Chapel Hill (NC); Remote; USD 28,000 - 40,000; Full time

Job summary

UNC Health is hiring a Senior Revenue Cycle Representative focused on pre-service insurance verification and Real-Time Eligibility (RTE). You will act as an advanced resource for complex eligibility investigations and lead optimization efforts, training teammates and supporting process improvements across UNC Health’s revenue cycle.

This position emphasizes advanced coverage verification, payer requirements, and quality review.

Qualifications

• Three (3) years of experience in Hospital or Physician Insurance related activities (Verification, Authorization, Billing, Follow-Up, Call-Center, or Collections).
• Experience with Epic eligibility workflows, workqueues, and coverage verification processes preferred.
• Experience training, onboarding, mentoring, or coaching staff preferred

Responsibilities

• Perform advanced insurance coverage verification and benefit investigation activities.
• Investigate and troubleshoot complex eligibility and Real-Time Eligibility (RTE) issues.
• Identify recurring payer, benefit, workflow, or system-related trends affecting verification accuracy.
• Serve as a subject matter expert for coverage verification workflows, payer requirements, benefit interpretation, and eligibility processes.
• Conduct quality audits to evaluate documentation accuracy, verification quality, adherence to department procedures, and consistency of work performed.
• Provide constructive feedback and coaching based on quality review findings.
• Assist with onboarding, training, and mentoring newly hired Revenue Cycle Representatives.
• Develop and maintain training materials, tip sheets, standard operating procedures, and workflow documentation.
• Monitor quality trends and identify opportunities for process improvement and staff development.
• Escalate high-impact payer, system, and eligibility issues to leadership.
• Participate in workflow redesign, process improvement, reporting, and automation initiatives.
• Support departmental projects, testing efforts, and implementation of new verification workflows.
• Serve as an operational resource and escalation point for complex payer and coverage questions.

Skills

Insurance verification

Real-Time Eligibility

Training & mentoring

Analytical skills

Customer service

Education

High school diploma or GED

Tools

Epic eligibility workflows

MS Office

Job description

UNC Health is hiring a Senior Revenue Cycle Representative focused on pre-service insurance verification and Real-Time Eligibility (RTE). You will act as an advanced resource for complex eligibility investigations and lead optimization efforts, training teammates and supporting process improvements across UNC Health’s revenue cycle.

This position emphasizes advanced coverage verification, payer requirements, and quality review.