Revenue Cycle Representative - Physician Ins Billing and Foll
Company: UNC Health Care Systems
Location: Chapel Hill
Posted on: May 4, 2021
Description Become part of an inclusive organization with over
30,000 diverse employees, whose mission is to improve the health
and well-being of the unique communities we serve. Job
Summary:Responsible for performing a variety of complex duties,
including but not limited to, working outstanding insurance claims
follow up for no response from payors, and/or claim denials.
Maintains A/R at acceptable aging levels by prompt follow-up of
unpaid claims and denied claims. Performs all duties in a manner
which promotes teamwork and reflects UNC Health Care's mission and
philosophy. This position will report to the Medicaid Follow Up
Team Description of Job Responsibilities: Responsible for the
accurate and timely submission of claims follow up, reconsideration
and appeals, response to denials, and re-bills of insurance claims,
and all aspects of insurance follow-up and collections including
interfacing with internal and external departments to resolve
discrepancies through charge corrections, payment corrections,
write-offs, other methods.
- Research medical records to gather information and substantiate
medical justification for procedures as required by insurance
carriers. Submits requested medical information to insurance
- Responsible for the analysis and necessary corrections of
invoices or accounts and maintaining work queues. Access, review
and respond to third party correspondence.
- 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 insurance companies to obtain information necessary for
invoice or account resolution through write-offs, reversals,
adjustments or other methods.
- Verify claims adjudication utilizing appropriate resources and
applications. 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 PB Claims operations. Evaluate carrier and
departmental information and determines data to be included in
- 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. Meets/Exceeds Productivity and Quality standards.
Education Requirements: High school diploma or GED.
Licensure/Certification Requirements: No licensure or certification
required. Professional Experience Requirements: One (1) year of
experience in Hospital or Physician Insurance related activities
(Authorization, Billing, Follow-Up, Call Center, or Collections)
Knowledge, Skills, and Abilities Requirements: Good written and
verbal communication skills. Intermediate technical skills
including PC and MS Outlook. Intermediate knowledge of UB-04, HCFA
1500, and Explanation of Benefits (EOB) interpretation.
Intermediate knowledge of insurance collections and insurance
terminology. Knowledge of 3rd party reimbursements from insurance
companies and government payers is a plus Other Information 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
Keywords: UNC Health Care Systems, Chapel Hill , Revenue Cycle Representative - Physician Ins Billing and Foll, Healthcare , Chapel Hill, North Carolina
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