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Job ID: 23363
Location: Raleigh, NC
Facility/Division: Shared Services
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.
This Revenue Cycle Representative will be a member of the Pre-Services Rex Surgery team. This team is responsible for insurance verification and obtaining authorization for surgery services provided within the UNCHCS. This position is located at the Rex Pre-Arrival Unit. This position interacts will be responsible for performing a variety of complex duties, including but not limited to working with third party insurers via internet & telephone to verify patient insurance and benefits and submit necessary information to obtain authorization for scheduled services. This position interacts with patients, physician offices, financial navigators and clinic staff to ensure accurate information and communicate patient eligibility/authorization status for coordination of services. Successful candidates will be able to work independently, have strong communication skills, well organized with strong attention to detail.
This position qualifies for a $5,000 commitment incentive, paid over a three (3) year commitment. Payment of $1,500 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
• Responsible for all aspects of authorizations including insurance verification and authorization submission for medical procedures. Contacts insurance carriers to obtain authorizations and referral approvals for services and procedures. Researchers medical records to gather information and substantiate medical justification for procedures as required by insurance carriers. Submits requested medical information to insurance carrier.
• Responsible for maintaining work queues. Accesses, reviews and responds to third party correspondence via email or phone. Contacts patients, physicians and insurance companies to obtain information necessary for procedure authorizations.
• Maintains basic understanding and knowledge of health insurance plans, policies and procedures. Accurately and thoroughly documents the pertinent collection activity performed. Participates and attends meetings, training seminars and in-services to develop job knowledge. Meets/Exceeds Productivity and Quality standards.
● High School Degree
Professional Experience Requirements:
● Two (2) years of experience in hospital or physician insurance related activities ((Authorization, Billing, Follow-Up, Call-Center, or Collections)
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Pre-Arrival Unit
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Raleigh
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.