[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.
• Editing claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority.
• Contacting insurance carriers to obtain authorizations and referral approvals for services and procedures.
• Researching medical records to gather information and substantiate medical justification for procedures.
• Submitting requested medical information to insurance carriers.
• Analyzing and correcting patient invoices or accounts for clean claim submissions or re-bills.
• Maintaining work queues and accessing, reviewing, and responding to third party correspondence.
• Researching and resolving issues relating to posting of payments and charges, insurance denials, secondary billing issues, credit balances, and non-payment of claims.
• Contacting patients, physicians, and insurance companies for information necessary for invoice or account resolution.
• Verifying claims adjudication utilizing appropriate resources and applications.
• Posting payments (Insurance and/or Patient) and denials to patient invoices/accounts in a timely and accurate manner.
• Reconciling accounts and responding to assigned correspondence in a timely, professional, and complete manner.
• Identifying issues and/or trends and providing suggestions for resolution to management.
• Maintaining data tables for systems that support Patient Accounting operations.
• Reading and interpreting EOB's (Explanation of Benefits).
• Maintaining basic understanding and knowledge of health insurance plans, policies, and procedures.
• Accurately documenting the pertinent collection activity performed.
• Participating in meetings, training seminars, and in-services to develop job knowledge.
• Meeting/Exceeding Productivity and Quality standards.

Benefits

• Salary Range: $18.48 - $25.89 per hour (Hiring Range).
• Work Type: Full Time.
• Standard Hours Per Week: 40.00.
• Work Assignment Type: Remote.
• Work Schedule: Day Job.
• Exempt From Overtime: Exempt: No.