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Job Summary
Responsible for performing a variety of complex duties in support of reimbursement from patient and insurance carriers throughout the revenue cycle follow-up and collections. Requires substantial knowledge of all carrier policies, procedures and practices necessary to collect carrier accounts receivable and resolve credits. Participates and assists in special projects. Perform all duties in a manner which promotes teamwork and reflects UNC Health Care?s mission and philosophy.
Description of Job Responsibilities:
Performs complex credit analysis.
Resolve credits through generating refunds and/or posting adjustments in accordance with UNC-H policies and procedures while maintaining rigorous quality and productivity standards.
Research and rework returned refunds.
Mail refunds to various insurance carriers, payers and patients.
Ensure charges are entered/posted for billing in accordance with the patient?s chart.
Ensure proper posting/distribution of patient payments.
Analyze/Manage patient account for overpayments.
Locate missing patient payments.
Manage and maintain pre-payments for OB, Ortho surgery, DME and circumcision accounts as well as OPTH, Bariatric and ELP/Cosmetic case rate agreements.
Verify eligibility using various resources: Payer websites, calls to carriers and patients.
Manage Medicaid overpayments via the NC Tracks website.
Manage Medicare overpayments via E-services (Medicare website).
Analyze Transplant accounts to confirm overpayments
Ensure Agency payments (NAF/Worker?s Comp./Organ Procurement) are posted correctly
Other Information
Other information: Education Requirements: ? High school diploma or GED. Licensure/Certification Requirements: ? No licensure or certification required. Professional Experience Requirements: ? Two (2) years of experience in Hospital or Physician Insurance related activities or Call Center Customer Service experience. (Authorization, Billing, Follow-Up, Call-Center, or Collections). Knowledge/Skills/and Abilities Requirements: ? Excellent interpersonal, verbal and written communication skills. ? Excellent listening skills, and organizational skills. ? Advanced knowledge of UB-04, HCFA-1500?s and Explanation of Benefits (EOB) interpretation. ? Intermediate knowledge of CPT and ICD-9 codes. ? Advanced knowledge of insurance billing, collections and insurance terminology. ? Ability to work in fast pace environment and prioritize and manage multiple tasks. ? Healthcare terminology. ? Customer Service skills. ? Computer knowledge: MS Word, Excel, and Outlook. ? Knowledge of 3rd party reimbursements from insurance companies and government payers is a plus.
Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Cash Management
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $18.84 - $26.77 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 race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
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.
UNC Health is charting a new course for the organization, one that reflects our aspirations, values and the high expectations customers have in today’s healthcare marketplace. These changes will help the organization adopt business and medical practices that will help us become a more responsive, customer-focused, integrated healthcare system. UNC Health and its 33,000 employees, continue to serve as North Carolina’s Health Care System, caring for patients from all 100 counties and beyond our borders. We continue to leverage the world class research conducted in the UNC School of Medicine, translating that innovation to life-saving and life-changing therapies, procedures, and techniques for the patients who rely on us.