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Job ID: 11434
Location: Eden, NC
Facility/Division: UNC Rockingham Health Care
Status: Full Time
Shift: Day Job
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.
Reviews, verifies, edits and submits/transmits claims and claims ata to third party payers, insurance carriers, federal and state governmental agencies. Assures claim and data submission is timely, accurate and compliant with third party payer requirements and federal and state regulations.
1. Conducts timely and effective follow-up and collection of claims submitted using the hospital automated financial systems, trial balances and other tools available for this purpose.
2. Initiates appeals on appropriate denials in order to improve cash.
3. Reviews third party payer payments, explanations of benefits/payments and other correspondence received to assure accurate processing has occurred. Initiates corrective action as indicated.
4. Researches, investigates and coordinates efforts with patients, third party payer organizations and internal staff to assure timely responses and action steps are taken in response to inquiries, questions, or concerns.
5. Maintains current knowledge of federal and state claim processing regulations and third party payer contracts, including payment rates and claims processing requirements and determines how to appropriately file claims.
6. Documents all claims processing, follow-up, collection, account inquiry resolution and reconciliation actions taken pursuant to departmental and hospital procedures.
7. Attends daily Administrative Team meeting. Updates daily census in Achieve billing system. Including registering patients and updating the ADT report. runs daily census report.
8. Enters new patients into system, generates new face sheets for all new admits.
9. Posts charges and payments to Achieve billing system. Process AP invoices (review invoice and code to correct account for AP) for Medicare A/HMO MD visits. Prepares daily deposits.
10. Balances Petty cash box, assists with reconciliation of Resident Trust and resident Council accounts. Provides frontline customer support to families with billing questions.
● Associate's degree (A.A.) or equivalent from a two-year college or technical school.
Professional Experience Requirements:
● Six months to one year related experience and/or training; or equivalent combination of education and experience.
● If a High School diploma or GED: 5 years experience.
Knowledge/Skills/and Abilities Requirements:
● Language Skills: Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to complex inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to effectively present information to top management, public groups, and/or boards of directors. Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.COMPUTER SKILLSAbility to use medical claims processing software. Working knowledge of Word, Excel, Achieve Pathlinks, and Microsoft Exchange. Proficient keyboarding skills. Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Legal Employer: NCHEALTH
Entity: UNC Rockingham Health Care
Organization Unit: MNC Administration
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Eden
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.