This job is closed
Applications are no longer available for this announcement. Explore current related opportunities below.
Job description
Description
nYour passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.
nSummary:
nThe Government-Non-government Specialist is responsible for reviewing, submitting and resolving assigned insurance accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines
nProcesses all assigned government and nongovernment accounts and denials for complex financial appeals, with a goal of bringing the accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines. Follows rules for overturning appeals and rejections for these accounts. Completes additional research and coordinates with other departments, physician offices and insurers. Also performs follow-up responsibilities of a financial counselor. Assists Revenue Cycle Director in maintaining accounts receivables at appropriate levels.
nSubmits insurance claims to the appropriate payers on a daily basis in adherence to applicable regulatory, legal, and compliance guidelines. Assists the Manager and Director in all aspects of claims processing.
nResponsibilities:
nnnWorks insurance related billing errors in Epic and SSI.
n
nnWorks accounts from follow up work queues in Epic.
n
nnWorks denials in Epic towards resolution.
n
nnCoordinates with other teams/departments/payors to resolve account errors.
n
nnPosts adjustments and write offs as needed.
n
nnLeverages Lead as a resource to address account issues and questions.
n
nnEnsures work queues are worked appropriately and timely.
n
nnSatisfies goals pertaining to audits, productivity and quality standards.
n
nnResponsible for the accurate and timely submission of claims, response to denials, and re-bills of insurance claims, and all aspects of insurance follow-up and collections.
n
nnInterfaces with internal and external departments to resolve discrepancies through charge corrections, payment corrections, write offs, refunds or other methods.
n
nnResearches and resolves 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. Contacts patients, providers and insurance companies to obtain information necessary for invoice or account resolution through write-offs, reversals, adjustments, refunds or other methods.
n
nnVerifies claims adjudication utilizing appropriate resources and applications. Reconciles accounts, researches and resolves a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, sequencing of charges, and non-payment of claims.
n
nnResponds to any assigned correspondence in a timely, professional, and complete manner.
n
nnParticipates and attends meetings, training seminars and in-services to develop job knowledge.
n
nnMeets or exceeds goals pertaining to productivity and quality expectations.
n
nnAssists in training teammates within the Government/Non-Government teams.
n
nnServes a resource and role model for other teammates in the area.
n
n nWAYNE
nOther information:
nEducation
nHigh School Diploma or equivalent required, any higher education from an accredited college will supersede this requirement.
nLicensure/Certification
nCRCR (Certified Revenue Cycle Representative) certification from HFMA within one year of hire.
nExperience
nTwo (2) years prior experience in Hospital or Physician Insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections).
nKnowledge, Skills and Abilities
n• Good organizational, follow up and attention to detail skills.
n• Excellent customer service and interpersonal skills.
n• Ability to read, write and communicate effectively in English.
n• Proficient with MS Office, Epic/ EMR software, with the ability to learn new software rapidly.
nValid NC Driver’s License: No
nIf driving a Wayne UNC Vehicle, must be 21 years old and MVR must be approved by Risk Management.
nBO-209
n .BO-209.NON-CLIN
nJob Details
nLegal Employer: Wayne Health
nEntity: Wayne UNC Health Care
nOrganization Unit: Patient Accounts
nWork Type: Full Time
nStandard Hours Per Week: 40.00
nWork Assignment Type: Hybrid
nWork Schedule: Day Job
nLocation of Job: WAYNE MED
nExempt From Overtime: Exempt: No
nQualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
nQualified 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.
Worksite address
goldsboro, NC, 27533, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.