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REVENUE CYCLE REPRESENTATIVE - PRE ARRIVAL UNIT

Company: UNC Health Care
Location: Asheville
Posted on: February 16, 2020

Job Description:

REVENUE CYCLE REPRESENTATIVE - PRE ARRIVAL UNITJob ID: FIN003MMBecome part of an inclusive organization with over 30,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.Job DescriptionThisposition may involve support of various hospitals and health care systemswithin the UNC Health Care System, but will be employed by Rex Hospital, Inc.(this includes, but is not limited to, for purposes of payroll, healthbenefits, retirement options, and applicable policies). Employees of an entitymanaged by UNC Health Care are external candidates and will be employed by RexHospital, Inc. if selected for the role.Job Summary:Responsible for performing a variety of complex duties, including but not limited to, working outstanding insurance claims having no response from payors, having claim edits, and/or having received claim form related denials. Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims and denied claims. Performs all duties in a manner which promotes teamwork and reflects UNC Health Cares mission and philosophy.Description of Job Responsibilities: Responsible 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 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, and 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 EOBs (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 standardsPreference/Asset Critical Thinking Skills are necessary to be successful in this role. A successful candidate will possess the skillset necessary to identify a problem or issue, determine why the problem exist, collect information or data on the issue through research, and develop/execute solutions. Epic and Authorization experience preferredQualificationsHigh School diploma or GED. Two (2) years of experience in Hospital or Physician Insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections)Primary Location: Chapel Hill, North Carolina, United StatesDepartment: 8000-77700-Pre-Arrival UnitShift: Day Job

Keywords: UNC Health Care, Asheville , REVENUE CYCLE REPRESENTATIVE - PRE ARRIVAL UNIT, Other , Asheville, North Carolina

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