CBO Insurance Appeals Specialist
6 months ago
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.
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