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/ Job Search / Government/Non-Government Specialist

Government/Non-Government Specialist

Job ID: 64226
Location: Goldsboro, NC
Facility/Division: Wayne UNC Health Care
Status: Full Time
Shift: Day Job

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Job Description

Description

Job Summary

The Government-Non-government Specialist is responsible for reviewing, submitting and resolving assigned insurance accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines

Processes all assigned government and nongovernment accounts and denials for complex financial appeals, with a goal of bringing the accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines. Follows rules for overturning appeals and rejections for these accounts. Completes additional research and coordinates with other departments, physician offices and insurers. Also performs follow-up responsibilities of a financial counselor. Assists Revenue Cycle Director in maintaining accounts receivables at appropriate levels.

Submits insurance claims to the appropriate payers on a daily basis in adherence to applicable regulatory, legal, and compliance guidelines. Assists the Manager and Director in all aspects of claims processing.

    Minimum Qualifications

    Education

    High School diploma or GED required.

    Licensure/

    Certification

    CRCR (Certified Revenue Cycle Representative) certification from HFMA within one year of hire.

    Experience

    Two (2) years prior experience in Hospital or Physician Insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections).

    Knowledge, Skills and Abilities

    · Good organizational, follow up and attention to detail skills.

    · Excellent customer service and interpersonal skills.

    · Ability to read, write and communicate effectively in English.

    · Proficient with MS Office, Epic/ EMR software, with the ability to learn new software rapidly.

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    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

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