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Denial Specialist - Physician Insurance Billing and Follow-Up

This job posting is no longer active.

Job ID: 10622
Location: Chapel Hill, NC
Facility/Division: Shared Services
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


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.

The Physician Insurance Billing and Follow Up department ("PB Claims") is looking for seasoned professional billing experts to join our Projects, Quality, Systems, and Training ("PQST") team. Members of this team report to our department's quality manager. The team is currently composed of four Denial Specialists. 

This role acts as a project manager and subject matter expert for an assigned subset of claims and/or business. Assignments can be based on dollar threshold, payor issue type, functional area support type, or complexity of individual patient accounts. This work spans from pre-claims to post-resolution review. To facilitate this, team members must work closely with management and other teams in our department as well as peers on the team, embodying UNC Health's value of One Great Team. 

The candidate will need to be self-sufficient, organized, and adaptable. Must be able to take clear ownership of assigned work and manage reasonable challenges, in accordance with UNC Health's value of It Starts With Me. The ideal candidate will seek opportunities to improve our process, documentation, and/or system programming - manifesting UNC Health's value of Leading the Way.

Quality Audits: Perform data-driven audits across all billing teams in PB Claims. Our team uses data visualization applications to review all possible user actions within a particular behavior, rather than relying on random sampling. Auditors must be able to look at both aggregated data as well as drilling down into identified samples to provide auditing-as-a-service to our teams. 

Customer Relationship Management (CRM): Coordinate with UNC Health's Call Center and other relevant departments to troubleshoot complex customer complaints. Resolutions must balance the requirements of our various policies while still embodying UNC Health’s value of Carolina Care. In addition to working requests based on the insurance payor, this position also manages special CRM work sent by Patient Relations and Risk Management. 

Training/Onboarding: Conduct live sessions and check-ins with new hires going through our remote onboarding program. Revise and update onboarding curriculum in response to changing needs or to improve overall quality of materials. 

AR Management: Highly complex issues will be removed from payor teams' regular production AR and transferred to the Denial Specialist to ensure that it is being resolved thoroughly and in a timely fashion. 

AdHoc Support: Provide support to bridge gaps in staffing, facilitate team-wide trainings on new initiatives, or act as a liaison between the Billing & Follow-up team and its peer groups by managing specific types of inter-departmental work. 

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


● Three years of direct experience working in PB Revenue Cycle, preferably with experience as a team lead or "senior" role. 

● Knowledge of Epic's Resolute Billing Module is strongly preferred and experience with UNC Health’s operational processes is a plus. 

● Coding certification (CPC, etc.) is a plus, though not required. 

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Physician Ins Billing and Foll 

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

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care. This is not a State employed position.
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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 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.

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