Join our Talent Network
Skip to main content

*Important Notice:

Applying for Jobs:

Thank you for your continued interest in career opportunities with UNC Health! Please note the following:

  • Current teammates of UNC Health looking to apply for a position outside of their current payroll entity, please close this notice and continue your job search and application as an external applicant. Please be sure to use your personal email address and not your UNC Health email address.
  • Current teammates of UNC Health looking to apply for a position within their current payroll entity, please apply as an internal applicant through Employee Self Service. Teammates applying internally, please be sure to have your teammate ID and UNC Health email address redily availble.

Discovery Teammate Referral Program:

**This referral program is applicable to teammates within UNC Health's core facilities and divisions. This includes UNC Health Caldwell, UNC Health Chatham, UNC Health Alliance, UNC Hospitals (UNC Medical Center, UNC WakeBrook, UNC Hillsborough, and UNC Faculty Physicians), UNC Health Johnston, UNC Physicians Network, UNC Health Rex, UNC Rex Holly Springs, UNC Health Rockingham, and Shared Services.**

Current teammates, looking to refer someone? Check out our Teammate Referral Program to earn extra cash!

Current teammates, please ensure that you submit your candidate in our system, before they apply. For teammate referral guidelines and eligibility, click here.

myCareer Development Resources:

Current UNC Health teammates also now have access to our myCareer - Career Development Resources, which provide tools and guidance to employees to create a career plan.

Questions:

Need further assistance? Please submit a request through the myHR Portal.

Denial Specialist

Job ID: 50879
Location: Smithfield, NC
Facility/Division: Johnston Health
Status: Full Time
Shift: Day Job

Did you know UNC Health has Ranked #2 Most Trusted Healthcare Brand in the U.S.? The UNC Health brand was ranked as the #4 healthcare brand in the United States overall and the #2 most trusted healthcare brand, just after Johns Hopkins and before Mass General. Join our One-Great-Team!

Job Description

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
The Denial Specialist is responsible in the timely and appropriate validation and follow up of denied claims. They thoroughly investigate denied claims and address them by assigning the appropriate resources with the denial management process.

Responsibilities:

1. Analyzes denials and appeals pattern for trends. Provides information to leadership regarding patterns or trends (practitioners, diagnosis, patient location) associated with appeals.
2. Assigns expected value (payment) of care. Acts as a resource to staff relative to concurrent and retrospective denials of payment and services relative to the appeal process.
3. Attends appeal hearings as appropriate to represent the institution. Appeals denials based on medical necessity. Completes all necessary paperwork.
4. Notes due date for research and completion. Updates HIS status of denial.
5. Participates with Managed Care Department in reviewing payor contracts to assess the feasibility of the reviews being requested. Concurrent problem solving and prevention of pending denials in collaboration with care managers. Extracts from the medical record clinically pertinent information to respond to demands and develop concise action steps based on payor letter codes reason for denial.


Other Information

Other information:
Education Requirements:
● High School diploma or GED
Licensure/Certification Requirements:
● No licensure or certification required.
Professional Experience Requirements:
● Three (3) years of experience in a clerical, accounting or customer service setting or an equivalent combination of education, training and experience
Knowledge/Skills/and Abilities Requirements:


Job Details

Legal Employer: NCHEALTH

Entity: Johnston Health

Organization Unit: Business Office

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Schedule: Day Job

Location of Job: US:NC:Smithfield

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 Heath Care System. This is not a State employed position.


Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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 [email protected] if you need a reasonable accommodation to search and/or to apply for a career opportunity.

Share: mail
Testimonial: Jackie image
Testimonial: Namoi Hunt image
Testimonial: Letisha Guasp image
Testimonial: Kurt Kremer image
Testimonial: Jacob Jacoby image
Testimonial: Bianca Contreras image
Testimonial: Madeline White image
Testimonial: Thomas Johnson image
Testimonial: Kristin Mooring image
Testimonial: Tamara Leary image
Recent Job Searches
Recently Viewed Jobs

Diversity Statement

The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.

Equal Employment Opportunity

UNC Health is an equal opportunity and affirmative action employer.

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.

All interested applicants are invited to apply for career opportunities. Please refer to our Employment Application Accessibility page if you need a reasonable accommodation to search and/or to apply for a career opportunity.

To verify employment eligibility, UNC Health is committed to Form I-9 and the E-Verify process.

Learn further E-Verify details in E-Verify (English) or E-Verify (Spanish).

UNC Health supports your right to work. View the Right of Work Statement (English) or Right of Work Statement (Spanish).

View the KNOW YOUR RIGHTS (English) or the KNOW YOUR RIGHTS (Spanish)posters.

View the PAY TRANSPARENCY (English) or the PAY TRANSPARENCY (Spanish)Nondiscrimination provision posters.

View the Federal Workplace poster. View our EEO/AA Policy Statement.