[Hiring] Revenue Cycle Representative @UNC HEALTH

Role Description

May be responsible for performing a variety of complex duties, including but not limited to:

• Working outstanding insurance claims having no response from payors.
• Handling claim edits and/or claim form related denials.
• Maintaining A/R at acceptable aging levels by prompt follow-up of unpaid claims and denied claims.
• Reviewing credit balances for possible reallocation or refunds.
• Posting payments, contractual adjustments, and denials in a timely, accurate, and complete manner.
• Processing paper correspondence as assigned.
• Performing all duties in a manner which promotes teamwork and reflects UNC Health's mission and philosophy.

Qualifications

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

Requirements

• 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.
• Edit claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority.
• 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.
• Maintain work queues 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, and credit balances.
• Contact patients, physicians, and insurance companies to obtain necessary information for invoice or account resolution.
• 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 and research issues relating to posting of payments and charges.
• Respond to assigned correspondence in a timely, professional, and complete manner.
• Identify issues and/or trends and provide suggestions for resolution to management.
• Maintain data tables for systems that support Patient Accounting operations.
• Evaluate carrier and departmental information for system tables.
• Read and interpret EOB's (Explanation of Benefits).
• Maintain basic understanding and knowledge of health insurance plans, policies, and procedures.
• Accurately 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.

Benefits

• Full Time position with standard hours of 40.00 per week.
• Salary Range: $18.48 - $25.89 per hour (Hiring Range).
• Work Assignment Type: Remote.
• Work Schedule: Day Job.

Company Description

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.

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.