Revenue Cycle Representative - Patient Accounting jobs in United States
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UNC Health · 7 hours ago

Revenue Cycle Representative - Patient Accounting

UNC Health is an inclusive organization dedicated to improving the health and well-being of the communities they serve. The Revenue Cycle Representative will perform complex duties related to insurance claims, manage accounts receivable, and ensure timely follow-up on unpaid claims and denials.

Addiction TreatmentHealth CareHealth DiagnosticsHospitalNon ProfitWellness

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
Submits 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
Meets/Exceeds Productivity and Quality standards

Qualification

Insurance BillingClaims Follow-UpPayment PostingMedical Records ResearchEOB InterpretationTeamworkCommunicationProblem Solving

Required

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

Company

UNC Health

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Our mission is to improve the health and well-being of North Carolinians and others whom we serve.

Funding

Current Stage
Late Stage

Leadership Team

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Chris Ellington
President UNC Health Care - Network Hospitals and EVP CFO UNC Hospitals at Chapel Hill
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Jeff Lindsay
President and Chief Operating Officer
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Company data provided by crunchbase