Revenue Cycle Representative

UNC Health•Chapel Hill, NC

23h•Remote

About The Position

The Revenue Cycle Representative performs insurance claim follow-up and revenue cycle work to maintain accounts receivable at acceptable aging levels. The role includes resolving unpaid and denied claims, reviewing credit balances for possible reallocation or refunds, and, as assigned, posting payments, contractual adjustments, and denials. The representative also processes paper correspondence and performs duties in a manner that promotes teamwork and reflects UNC Health’s mission and philosophy. This position supports UNC Health’s Patient Financial Experience Coverage Coordination unit. It is a full-time remote role with a day work schedule and 40 standard hours per week. The listed hiring salary range is $18.12–$25.51 per hour; offers are determined by experience and internal equity.

Requirements

High school degree.
Two years of experience in hospital or physician insurance-related activities, such as authorization, billing, follow-up, call-center, or collections.

Responsibilities

Submit insurance claims accurately and on time, respond to denials, and rebill claims.
Perform insurance follow-up and collections, coordinating with internal and external departments to resolve discrepancies through charge or payment corrections, write-offs, refunds, or other methods.
Edit claims within the scope of authority, or escalate as needed, to meet billing compliance guidelines for electronic submission.
Contact insurance carriers to obtain authorizations and referral approvals for services and procedures.
Research medical records to substantiate medical justification for procedures and submit requested medical information to insurance carriers.
Analyze and correct patient invoices or accounts for clean claim submissions or rebilling.
Maintain work queues and access, review, and respond to third-party correspondence through the Document Management system.
Research and resolve issues involving payment and charge posting, insurance denials, secondary billing, credit balances, charge sequencing, and unpaid claims.
Contact patients, physicians, and insurers to obtain information needed to resolve invoices or accounts through write-offs, reversals, adjustments, refunds, or other methods.
Verify claim adjudication using appropriate resources and applications.
Post insurance or patient payments and denials to patient invoices or accounts accurately and promptly.
Reconcile accounts and resolve issues involving payment and charge posting, insurance denials, secondary billing, charge sequencing, and non-payment.
Respond to assigned correspondence in a timely, professional, and complete manner.
Identify issues and trends and suggest resolutions to management, including payer, system, or escalated account issues.
Maintain system data tables that support Patient Accounting operations, as assigned, and evaluate carrier and departmental information to determine what data to include.
Read and interpret explanations of benefits (EOBs).
Maintain a basic understanding of health insurance plans, policies, and procedures.
Document collection activity accurately and thoroughly.
Attend meetings, training seminars, and in-services to develop job knowledge.
Meet or exceed productivity and quality standards.