UNC Health · 2 days ago

Revenue Cycle Representative - Physician Insurance Billing and Follow-Up

Chapel Hill, NC

Full-time

Hybrid

Entry, Mid Level

$17.50/hr - $24.63/hr

2+ years exp

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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.

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 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 system tables.

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

Maintain a 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.

Qualification

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