Revenue Cycle Financial Representative

UNC Health•Chapel Hill, NC

1d•Remote

About The Position

The Revenue Cycle Financial Representative performs complex pre-service, financial counseling, and customer service functions for patients and their representatives across hospital and physician services. The role creates pre-service estimates, explains benefits and patient liabilities, collects pre-payments and prior debt, obtains authorization requirements, answers billing questions, establishes payment plans, screens patients for financial assistance, and responds to MyUNCChart and other customer service inquiries. The representative supports estimate processes across clinical areas, including developing estimate templates and workflows, training staff, auditing estimate accuracy, and tracking collection trends. The role also handles insurance and billing requests, delinquent payment plan outreach, disputed Set Off Debt Collection Act accounts, escalated complaints, and client account billing and follow-up. Work involves coordinating with patients, clinical areas, internal departments, attorneys, the attorney general’s office, collection agencies, and other external customers.

Requirements

High school diploma or GED; a higher-level degree may satisfy this requirement.
Two years of experience in hospital or physician insurance-related activities or call-center customer service, such as authorization, billing, follow-up, call-center work, or collections.
Excellent interpersonal, verbal, and written communication skills.
Excellent listening and organizational skills.
Advanced knowledge of UB-04, HCFA-1500 forms, 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 a fast-paced environment and prioritize and manage multiple tasks.
Knowledge of healthcare terminology and customer service skills.
Computer knowledge, including MS Word, Excel, and Outlook.

Nice To Haves

Knowledge of third-party reimbursements from insurance companies and government payers is a plus.

Responsibilities

Create hospital and physician estimates using the Epic Patient Estimator, review eligibility and benefits through RTE, and obtain authorization requirements.
Contact patients before service to provide benefits and patient-liability education, explain estimate costs, and attempt to secure payment or set expectations for payment at the time of service.
Provide estimates to patient shoppers and clinical areas across the healthcare system.
Work with clinical areas to create estimate templates and determine workflows and processes; collaborate with ISD on template creation and rollout.
Provide payment plans for point-of-service collections.
Train clinical areas on estimate usage and patient collection scripting; audit estimates and provide feedback using Epic estimate reports.
Track and trend collection amounts and template accuracy using hospital and physician EOBs, and refine processes to improve accuracy.
Screen and assist patients with financial assistance, Medicaid eligibility, and other available funding sources.
Monitor and track routine follow-up on Medicaid and financial assistance approvals.
Handle hospital and physician billing inquiries through inbound calls, MyUNCChart, patient correspondence, and patient walk-ins.
Fulfill requests for charge itemizations; add, verify, and bill insurance; establish payment plans and payroll deductions; process adjustments and refund requests; and explain charity care policies and guidelines.
Initiate outreach on delinquent payment plans, add accounts to existing payment plans, and contact high-risk or high-balance accounts.
Investigate disputed hospital and physician SODCA accounts involving North Carolina state income tax refund withholds using current and legacy billing and imaging systems.
Meet with attorneys to record depositions, collaborate with the attorney general’s office, and attend or participate in hearings when needed.
Work with Patient Relations and Risk Management on escalated hospital and physician patient complaints or concerns.
Oversee hospital client account billing and follow-up, including validating charges and fee schedules, reviewing and moving charges, researching and reconciling payments, communicating with departments to answer client questions, and collecting payments.
Work with external customers, such as collection agencies and clinics, to address patient concerns.