CBO Insurance Appeals Specialist

4 months ago


Charlottesville, United States Commonwealth of Virginia Full time
This position analyzes accounts receivable and takes appropriate action to resolve coding and global denials.

Posts denials/rejects into EPIC billing system. Works complex denials with a high degree of accuracy and timeliness. Responds to inquiries from patients, clinical departments, and third parties by way of telephone, written correspondence and personal contacts. Adds/corrects registration, insurance, and demographic data in the EPIC billing system to ensure accurate records. Analyzes and prepares applicable adjustments to physicians’ fees in compliance with established guidelines. Processes adjustments as requested by the Departments and/or Supervisors. Obtains necessary information and records for researching and resolving accounts. Sends requests to resolve misapplied payments and credit balances. Participates in special meetings and projects as required. Follows up with third party carriers to resolve issues and obtain payment by coordinating resolution to rejected, denied, and outstanding claims to ensure timely collections. Analyzes accounts that are not resolved within the time specified by the contract using their knowledge of coding and utilizing various tools of CPT and ICD-10 to determine causes of unresolved issues. Selects the most efficient and effective follow up strategy to resolve the accounts to obtain reimbursement. Must be aware of carrier policies and guidelines. Works directly with departments and carriers on denial resolution. Participates in on-going training to maintain coding certification through AAPC. Other duties as identified by Unit Coordinator, Supervisor and/or Manager. Position Compensation Range: $18.37 - $28.47 Hourly

MINIMUM REQUIREMENTS
Education:

High School Diploma or GED

Experience:

Two years relevant office experience required.

Experience in insurance field preferred.

Experience utilizing EPIC or other medical billing system required.

Licensure:

CPC required or two years of insurance follow-up experience.

PHYSICAL DEMANDS
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs.

The University of Virginia, i ncluding the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician’s Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.

  • Charlottesville, United States University of Virginia Full time

    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...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job SummaryThe Central Billing Office (CBO) Insurance Resolution Specialist plays a critical role in ensuring accurate and timely reimbursement from insurance companies for UVA Health System facilities. This position requires strong analytical and communication skills to resolve complex billing and denial issues.Key ResponsibilitiesPerform inpatient and...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job SummaryThis role is responsible for analyzing accounts receivable and taking appropriate action to resolve coding and global denials. The successful candidate will have a strong understanding of medical billing systems and insurance regulations.Key ResponsibilitiesPost denials/rejects into EPIC billing systemWork complex denials with a high degree of...


  • Charlottesville, United States Commonwealth of Virginia Full time

    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...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job Title: Insurance Appeals Coordinator at Commonwealth of Virginia This role is essential for managing and resolving insurance appeals and denials effectively. Key responsibilities include:Entering denials and rejections into the billing system with accuracy.Addressing complex denial cases with attention to detail and efficiency.Communicating with...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Position OverviewThe Insurance Resolution Specialist within the Central Billing Office (CBO) is tasked with managing and addressing all insurance billing follow-ups and denial matters. This role is essential in ensuring that all facilities within the Commonwealth of Virginia's health system receive accurate reimbursements from insurance providers.Key...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Position OverviewThe Insurance Claims Resolution Specialist plays a critical role in the Central Billing Office (CBO) by managing and resolving various insurance billing follow-ups and denial challenges. This position is essential to ensure that all facilities within the Commonwealth of Virginia receive accurate reimbursements from insurance providers.Key...

  • Judicial Law Clerk

    2 weeks ago


    Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job SummaryThe Commonwealth of Virginia is seeking highly qualified applicants for a Judicial Law Clerk position in the Court of Appeals. As a Judicial Law Clerk, you will play a critical role in supporting the Judge in preparing memoranda, drafting court orders, and collaborating with other clerks and court members to resolve cases.Key...

  • Judicial Law Clerk

    3 weeks ago


    Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job SummaryThe Commonwealth of Virginia is seeking a highly skilled and detail-oriented Judicial Law Clerk to join our team in Charlottesville. As a Judicial Law Clerk, you will play a critical role in supporting the Court of Appeals of Virginia, working closely with Judge Lisa M. Lorish and other court staff.Key ResponsibilitiesPrepare memoranda for Judge...

  • Judicial Law Clerk

    2 weeks ago


    Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    {"Job Title": "Judicial Law Clerk", "Job Summary": "The Commonwealth of Virginia is seeking a highly skilled and motivated Judicial Law Clerk to join our team at the Court of Appeals. As a Judicial Law Clerk, you will have the opportunity to work closely with Judge Lisa M. Lorish and contribute to the decision-making process of the court.Responsibilities:*...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job SummaryThe Manager, Revenue Cycle Central Business Office (CBO) is responsible for overseeing the daily operations of assigned staff within CBO for UVA Health. This role ensures that assigned staff meet or exceed service goals, requiring critical thinking skills, decisive judgment, and the ability to work with minimal supervision. The Manager serves as a...

  • Revenue Cycle Manager

    2 weeks ago


    Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job SummaryWe are seeking a highly skilled Revenue Cycle Manager to oversee the daily operations of our Central Business Office (CBO) team. As a key member of our healthcare operations team, you will be responsible for ensuring the efficient collections of accounts and meeting/exceeding service goals.Key ResponsibilitiesManage and oversee the assigned staff...


  • Charlottesville, Virginia, United States Virginia Jobs Full time

    Position Overview: The Clinical Utilization Specialist plays a pivotal role in the Utilization Management process, acting as a key resource under general supervision. This position involves collaboration with healthcare professionals to ensure adherence to regulatory standards and promote optimal patient care.Key Responsibilities:Documentation Analysis:...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Job Title: Healthcare Audit Response SpecialistJoin our esteemed organization as a Healthcare Audit Response Specialist. We are seeking a meticulous professional who will oversee all audit-related activities concerning various programs and payers, ensuring prompt evaluation of audit results and timely submission of appeals.Systematically organize and manage...


  • Charlottesville, Virginia, United States CommuniCare Family of Companies Full time

    Job SummaryThe Regional Medicaid Specialist position provides critical support in coordinating financial benefits for residents in our Caring Communities. This role requires a dynamic individual with prior experience in Business Office or Admissions in Long Term Care.Key ResponsibilitiesAssist facilities in gathering financial data from residents, families,...


  • Charlottesville, Virginia, United States CommuniCare Family of Companies Full time

    Job SummaryThe Regional Medicaid Specialist position at CommuniCare Family of Companies provides an opportunity to make a meaningful impact in the lives of our residents and their families. As a key member of our team, you will play a critical role in ensuring that our residents receive the financial benefits they deserve.Key ResponsibilitiesAssist...


  • Charlottesville, United States CommuniCare Health Services Corporate Full time

    Regional Medicaid Specialist, VirginiaCommunicare Health Services is currently recruiting a dynamic individual with prior Business Office or Admissions experience in Long Term Care for the position of Regional Medicaid Specialist for our facilities located in Virginia. JOB SUMMARYThe position of Medicaid Specialist provides assistance with the coordination...


  • Charlottesville, Virginia, United States Commonwealth of Virginia Full time

    Position Overview:Under general supervision, the Utilization Management Registered Nurse acts as a pivotal resource in the Utilization Management framework. This role involves collaboration with physicians and various healthcare professionals to ensure adherence to regulatory standards and compliance.Key Responsibilities:Assessment of Medical Documentation:...


  • Charlottesville, Virginia, United States CommuniCare Family of Companies Full time

    Job SummaryThe Regional Medicaid Specialist position provides assistance with the coordination of financial benefits available to residents in our Caring Communities. This role requires a dynamic individual with prior Business Office or Admissions experience in Long Term Care.Key ResponsibilitiesAssist facilities with gathering financial data from residents,...


  • Charlottesville, Virginia, United States CommuniCare Family of Companies Full time

    Job SummaryThe Regional Medicaid Specialist plays a critical role in ensuring the financial well-being of our residents by coordinating the application process for Medicaid benefits. This position requires a strong understanding of Medicaid laws and regulations, as well as excellent communication and organizational skills.Key ResponsibilitiesAssist...