Revenue Cycle Representative

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 role has a high focus on Registration and Insurance. Candidates are responsible for performing a variety of complex duties, including but not limited to, researching and updating patient registration, calling insurance carriers to obtain policy information, working outstanding insurance claims having no response from payors, having claim edits, and / or having rejections from payor systems due to Registration errors.

Candidates will maintain A / R at acceptable aging levels by working down work queue populations according to designated tasks / assignments.

Candidates are expected to perform all duties in a manner which promotes teamwork and reflects UNC Health's mission and philosophy.

Candidates 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.

Responsibilities :

Review and analysis of registration : Understanding how to term, add, research and fix coverages at registration, edit claims (Coverage Changes, Registration updates and Claim Edits) within scope of authority (or escalate as needed) to meet and satisfy billing compliance guidelines for electronic submission.

Responsible for the analysis and necessary corrections of patient invoices or accounts as it pertains to clean claim submissions or re-bills.

Maintain basic understanding and knowledge of health insurance plans, policies and procedures.

Insurance Research : Contact insurance carriers to obtain patient eligibility and claim submission information. Research medical records to gather information that may related to Workers Compensation injuries and billing.

Research 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. Verify claims adjudication utilizing appropriate resources and applications.

Read and interpret EOB's (Explanation of Benefits).

Reporting and Research : Identify issues and / or trends and provide suggestions for resolution to management, including payer, system or escalated account issues.

Evaluate carrier and departmental information and determines data to be included in system tables.

Production and Quality : Candidates are responsible for meeting and maintaining production and quality standards. Responsible for maintaining work queues, and accurately and thoroughly documenting the pertinent collection activity performed.

Attend and participate in meetings, training seminars and in-services to develop job knowledge.

Other Information

Other information :

Education Requirements :

High School Degree

Licensure / Certification Requirements :

Professional Experience Requirements :

Two (2) years of experience in hospital or physician insurance related activities ((Authorization, Billing, Follow-Up, Call-Center, or Collections)

Knowledge / Skills / and Abilities Requirements :

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

Salary Range : $17.50 - $24.63 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type : Hybrid

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;

except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities.

All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.

unc.edu if you need a reasonable accommodation to search and / or to apply for a career opportunity.