Revenue Cycle Financial Representative - Customer Service Call Center

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.

***This position qualifies for a $5,000 commitment incentive, paid over a three (3) year commitment.  The first payment will be made within the first thirty (30) days of employment. The remaining will be paid after each six (6) month period of work completed. Learn more here:https://jobs.unchealthcare.org/pages/revenue-cycle-commitment-incentive-program***

Job Summary: 

THIS IS A CALL CENTER POSITION - This Revenue Cycle Financial Representative will be a member of the Financial Billing Call Center Team. This team is responsible for handling inbound and outbound calls regarding billing and insurance related questions for hospital and physician visits provided within the UNC Health Care System. This position is located at the Chapel Hill - Eastowne Office within the Call Center and Customer Service department. This position will be responsible for performing a variety of complex customer service related functions for patients and/or their representative including collection of prior debt, addressing billing questions, establishing payment plans and responding to MyUNC Chart inquiries and other Customer Service requests. Successful candidates will be able to work independently, well organized and strong attention to detail and ability to multi-task. 

Note: This position is a hybrid team member position primarily working remotely with expectations of coming on-site as scheduled. 

Responsibilities: 

• Answer and respond to all UNC Health medical billing related customer concerns that are received by telephone, in person and/or writing, while meeting customer and departmental goals and objectives. 

• Answer and resolve all inbound inquiries and issues regarding patient account statements, bad debt, financial assistance and other questions. 

• Assist with explaining Explanation of benefits (EOBs), balance due, and other patient and insurance billing related scenarios. 

• Analyze the patient's problem or issue that is presented by collecting information and data and conducting thorough research of the EPIC patient systems, Onbase for documents that may have been imaged (EOBs, statements, admitting documentation, patient correspondence, etc.), Blue E and other sites as needed. 

• Update and document EPIC CRM, notes or system comment fields with all information (i.e. questions, answers, actions, follow up items required); route CRM as appropriate to ensure the proper internal collaboration occurs. • Follow through on all customer issues promptly and accurately until resolved. 

• Communicate with the patient, physicians, collection agency, internal departments and all other internal and external customers in a professional, courteous, and respectful manner. 

• Post customer service adjustments when supported by policy, contractual adjustments and other adjustments as deemed necessary following appropriate write off guidelines. 

• Update insurance information and file and/or appeal claims with insurance companies according to department guidelines. 

• Take appropriate actions to bill insurance companies or patients with corrected information including accepting and inputting secondary insurance information into the system and filing claims. 

• Research EOBs and payment detail to determine if a patient refund is necessary or determine the nature of the credit balance; coordinate patient refund requests with the credit balance department. 

• Validate that charges are correct and request coding review and audit when necessary. 

• Provide financial guidance (referral to financial assistance/charity care, payment arrangement vendor, etc.) to patients, guarantors, and attorneys regarding charges for health care services. 

• Assist patients that are requesting charity care by providing that patient a copy of the charity care application when requested. 

• Produce and mail itemized statements upon request. 

• Provide feedback regarding status of the application when requested from a patient. 

• Obtain and post credit card payments for accounts including authorized settlements within departmental guidelines. 

• Follow department policy necessary for charge corrections, transferring credits, coding changes, service and charge disputes, and locate payments. 

• Following appropriate policy, update all system information to accessible fields to include correct registration in formation, address, telephone numbers, guarantor information, employer in formation, insurance information, etc. 

• Identify trends in system problems, training or procedural concerns and share with Supervisor. 

• Adhere to all HIPAA and confidentiality guidelines. 

• Work with a diverse group of internal and external customers (i.e. attorneys, insurance companies, state agencies, physician offices, collection agencies, etc.). 

• Work as a team member towards common goals. 

• Adhere to a schedule to ensure customer availability and demonstrate flexibility to schedules according to patient or call volume or staffing needs. 

• Perform other related duties incidental to the work described herein. 

Other Information

Education Requirements:
● High school diploma or GED.
Licensure/Certification Requirements:
● No licensure or certification required.
Professional Experience Requirements:
● Two (2) years of experience in Hospital or Physician Insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections).
Knowledge/Skills/and Abilities Requirements:
● Excellent interpersonal, verbal and written communication skills.
● Excellent listening skills, and organizational skills.
● Advanced knowledge of UB-04, HCFA-1500’s and Explanation of Benefits (EOB) interpretation.
● Intermediate knowledge of CPT and ICD-9 codes.
● Advanced knowledge of insurance billing, collections and insurance terminology.
● Ability to work in fast pace environment and prioritize and manage multiple tasks.
● Healthcare terminology.
● Customer Service skills.
● Computer knowledge: MS Word, Excel, and Outlook.
● Knowledge of 3rd party reimbursements from insurance companies and government payers is a plus.

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Customer Service Call Center 

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