Government Insurance Specialist
3 weeks ago
The Government-Non-Government Specialist at UNC Health is responsible for reviewing, submitting, and resolving assigned insurance accounts to an appropriate financial resolution in accordance with regulatory, legal, and compliance guidelines. This role involves processing all assigned government and non-government 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.
Key Responsibilities:
- Review and submit assigned insurance accounts for financial resolution.
- Process government and non-government accounts and denials for complex financial appeals.
- Follow rules for overturning appeals and rejections for these accounts.
- Complete additional research and coordinate with other departments, physician offices, and insurers.
- Perform follow-up responsibilities of a financial counselor.
- Assist the Revenue Cycle Director in maintaining accounts receivables at appropriate levels.
- Submit insurance claims to the appropriate payers on a daily basis in adherence to applicable regulatory, legal, and compliance guidelines.
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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