Government/Non-Government Specialist - UNC Health : Job Details

Government/Non-Government Specialist

UNC Health

Job Location : Goldsboro,NC, USA

Posted on : 2024-10-22T06:29:57Z

Job Description :
Job Summary The Government-Non-governmentSpecialist is responsible for reviewing, submitting and resolving assigned insurance accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines Processes all assigned government and nongovernment accounts and denials for complex financial appeals, with a goal of bringing the accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines. Follows rules for overturning appeals and rejections for these accounts. Completes additional research and coordinates with other departments, physician offices and insurers. Also performs follow-up responsibilities of a financial counselor. Assists Revenue Cycle Director in maintaining accounts receivables at appropriate levels. Submits insurance claims to the appropriate payers on a daily basis in adherence to applicable regulatory, legal, and compliance guidelines. Assists the Manager and Director in all aspects of claims processing. Minimum Qualifications Education High School diploma or GED required. Licensure/ Certification CRCR (Certified Revenue Cycle Representative) certification from HFMA within one year of hire. Experience Two (2) years prior experience in Hospital or Physician Insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections). Knowledge, Skills and Abilities •Good organizational, follow up and attention to detail skills. •Excellent customer service and interpersonal skills. •Ability to read, write and communicate effectively in English. •Proficient with MS Office, Epic/ EMR software, with the ability to learn new software rapidly.
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