Revenue Cycle Representative
Role Overview
The Revenue Cycle Representative is responsible for performing a variety of complex revenue cycle duties in support of the revenue cycle, from pre-service activities such as prior authorizations or insurance verification to post-service billing, follow-up, and collections.
The current focus of this position is pre-service insurance coverage verification, including reviewing assigned work queues, validating eligibility and benefits, resolving routine coverage discrepancies, documenting findings, and escalating issues as appropriate. The role supports a positive patient financial experience and, as departmental, organizational, or enterprise needs evolve, may support alternative revenue cycle functions or workflows. All duties are performed in a manner that promotes teamwork and reflects UNC Health’s mission and philosophy.
Key Skills for This Role
Full Job Posting
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Summary:
The Revenue Cycle Representative is responsible for performing a variety of complex revenue cycle duties in support of the revenue cycle, from pre-service activities such as prior authorizations or insurance verification to post-service billing, follow-up, and collections.
The current focus of this position is pre-service insurance coverage verification, including reviewing assigned work queues, validating eligibility and benefits, resolving routine coverage discrepancies, documenting findings, and escalating issues as appropriate. The role supports a positive patient financial experience and, as departmental, organizational, or enterprise needs evolve, may support alternative revenue cycle functions or workflows. All duties are performed in a manner that promotes teamwork and reflects UNC Health’s mission and philosophy.
Responsibilities:
- Work assigned Epic coverage verification work queues.
- Verify insurance eligibility and benefits using Real-Time Eligibility (RTE) tools, payer websites, and other approved resources.
- Research and resolve routine coverage verification discrepancies.
- Document verification findings accurately within Epic.
- Maintain productivity, quality, and service standards.
- Escalate complex payer, benefit, or eligibility issues to leadership or designated subject matter experts.
- Collaborate with scheduling, registration, financial counseling, and clinical departments.
- Participate in training and continuous improvement activities.
- Maintain compliance with organizational policies regarding privacy, confidentiality, and documentation.
- Perform other revenue cycle functions and related operational duties as assigned, consistent with the job classification, training, and evolving needs of the department and enterprise.
Other Information
Other information:
Education Requirements:
● High School Degree
Licensure/Certification Requirements:
- No licensure or certification required.
Professional Experience Requirements:
- Two (2) years of experience in Hospital or Physician Insurance related activities (Verification, Authorization, Billing, Follow-Up, Call-Center, or Collections).
- Epic experience preferred.
Knowledge/Skills/and Abilities Requirements:
- Knowledge of commercial, Medicare, Medicaid, and managed care plans.
- Strong attention to detail and critical thinking skills.
- Ability to manage multiple priorities and meet established productivity goals.
- Intermediate technical skills including PC and MS Office.
Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: PFE Coverage Coordination
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $18.48 - $25.89 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Remote
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [email protected] if you need a reasonable accommodation to search and/or to apply for a career opportunity.
About UNC Health
Integrated academic health care system serving North Carolina.
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