CBO Insurance Resolution Specialist

University of Virginia•Charlottesville, VA

39d•$18 - $35

About The Position

The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities within UVA Health System receives correct reimbursements from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and state requirements and also meeting the requirements of payers. The incumbent will serve as the liaison between insurance companies, patients and the departments to ensure the claims are processed and followed up to meet the CBO Revenue Cycle performance metrics & representative Facility specific goals. They will also research and answer all questions and complaints regarding patient responsibility balances and billing inquiries sent to them through the customer call center with the highest degree of courtesy and professionalism. The representative utilizes multiple electronic billing, hospital information systems and payer websites as well as the knowledge of medical billing and coding guidelines to resolve insurance denials and guarantor/patient inquiries. The representative must be able to respond knowledgeably to a wide range of billing and complex denial issues when dealing with insurance companies. The goal is to resolve all of the billing/denial issues through positive relationships/communication with the insurance companies, patients and internal customers.

Requirements

Education: High School Graduate or Equivalent
Experience: 2 years of relevant experience.
Licensure: None required

Responsibilities

Performs inpatient/outpatient billing process for multiple different facility types within UVA Health that the Central Billing Office has assigned AR responsibility.
Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and departmental rules.
Resolves insurance billing/payments collection process through proven knowledge of revenue cycle.
Performs optimum customer service to all inquiries from insurance companies. UVA Health clinical departments and patients.
Performs analysis of patient accounts to insure efficient and timely adjudication.
Effectively evaluates expected reimbursement and payments to insure they are processed correctly for all lines of business and facilities assigned to the CBO.
Performs revenue cycle department functions to achieve department goals.
In addition to the above job responsibilities, other duties may be assigned