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Revenue Cycle Representative - Cash Management
Job ID: 28103
Location: Chapel Hill, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
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.
Summary:
This position will report to the Supervisor of Payment Posting and is responsible for posting payments and denials to claims filed directly to a patient's account, processing requested adjustments, and other insurance payment related research requests. Applicant must interact with insurance carriers in all aspects of claim resolution. Applicant must possess strong customer service skills, be a team player, have the ability to multitask and be detailed oriented. Must have excellent grammar and English usage skills and the ability to deal effectively with difficult situations and individuals. Must have the ability to read an EOB and various financial and/or insurance documents. Consistently contributes equally to meeting productivity and quality goals established for the work unit and/or consistently meets established individual productivity and quality goals. Must be prepared to work a set schedule during the last two business days of each month in accordance with our monthly goal push.
***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***
Responsibilities:
- Responsible for the accurate and timely submission of claims, response to denials, and re-bills of insurance claims. Responsible for all aspects of insurance follow-up and collections including interfacing with internal and external departments to resolve discrepancies through charge corrections, payment corrections, writeoffs, refunds or other methods. Edit claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority (or escalate as needed) to meet and satisfy billing compliance guidelines for electronic submission. Contact insurance carriers to obtain authorizations and referral approvals for services and procedures. Research medical records to gather information and substantiate medical justification for procedures as required by insurance carriers. Submit requested medical information to insurance carrier.
- Responsible for the analysis and necessary corrections of patient invoices or accounts as it pertains to clean claim submissions or re-bills. Responsible for maintaining work queues. Access, review and respond to third party correspondence via Document Management system. Research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, credit balances, sequencing of charges, and non-payment of claims. Contact patients, physicians and insurance companies to obtain information necessary for invoice or account resolution through write-offs, reversals, adjustments, refunds or other methods. Verify claims adjudication utilizing appropriate resources and applications. Post payments (Insurance and/or Patient) and denials to patient invoices/accounts in a timely and accurate manner.
- Reconcile accounts, research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, sequencing of charges, and non-payment of claims. Respond to any assigned correspondence in a timely, professional, and complete manner. Identify issues and/or trends and provide suggestions for resolution to management, including payer, system or escalated account issues. May maintain data tables for systems that support Patient Accounting operations. Evaluate carrier and departmental information and determines data to be included in system tables. Read and interpret EOB’s (Explanation of Benefits).
- Maintain basic understanding and knowledge of health insurance plans, policies and procedures. Accurately and thoroughly document the pertinent collection activity performed. Participate and attend meetings, training seminars and in-services to develop job knowledge. Meet/Exceed Productivity and Quality standards.
Other Information
Education Requirements:
● 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). Prefer candidate that has medical billing experience. Epic experience is a plus.
Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Cash Management
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
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.
To verify employment eligibility, UNC Health is committed to Form I-9 and the E-Verify process. Learn further E-Verify details in English or Spanish.
UNC Health supports your right to work. View the Right to Work Statement in English or Spanish.
