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Job ID: 5584
Location: Chapel Hill, NC
Facility/Division: UNC Medical Center
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 30,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Performs complex duties in support of reimbursement from patients and insurance carriers for assigned clinical department. Duties include reversing denials from carriers, recoding denied claims, and identifying coding trends. Substantial knowledge of all carrier policies, procedures and practices is required to collect carrier accounts receivable, reverse denials, and expedite coverage to the uninsured. In addition, work requires knowledge of coding but not to the extent of classes in the Medical Coder series.
1. Collaborates with internal staff and Clinical departments regarding filing, documentation and reimbursement issues. Works closely with clinic staff to modify documentation, filing processes, and encounter forms to enhance billing and collection process
2. Evaluates accounts, billing, payments, coding, and posting of accurate charges for a highly specialized and complex medical service such as transplant. Researches and resolves denied claims with carrier and patients.
3. Identifies coding trends that do not support maximum reimbursement. Makes recommendations that will prevent or correct identified coding errors
4. May serve as a lead worker to provide problem resolution and assistance to lower level positions.
5. Researches and determines if carrier denial of claim is valid and if not, abstracts information from medical records to support appeal of carrier denials. Makes changes to original coding of charges in accordance with ICD-9 and CPT codes.
6. Serves as a resource for physicians, insurance carriers and patients to resolve questions/problems pertaining to patient accounts.
● High School diploma or GED
● No licensure or certification required.
Professional Experience Requirements:
● Three (3) years of experience in a clerical, accounting or customer service setting.
● Six (6) months of experience working with CPT and ICD-10.
Knowledge/Skills/and Abilities Requirements:
Legal Employer: STATE
Entity: UNC Medical Center
Organization Unit: Finance & Compliance Oncology
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
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.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.