UNC Health Care CLAIMS CODING SPECIALIST - UNCFP PAYMENT POSTING in Chapel Hill, North Carolina

CLAIMS CODING SPECIALIST - UNCFP PAYMENT POSTING

Job ID: OTH01MV1

Job Description

This position’s primary focus will be to ensure accurate and timely claims payment for the Assigned Departments claims; Conducting post payment review on claim denials, including follow up with payers to appeal denials or underpayments; Collaboration with Reimbursement, Professional Charges, and Clinic staff to address changes in regulations, reimbursement rules, claims documentation requirements, inappropriate filing or documentation patterns; Review of manual claims, determining documentation and information necessary to meet third party requirements, obtaining the information and filing the claim for processing. Requires medical terminology, and Medicare/Medicaid/Managed Care carrier knowledge. Prefer 2 years experience with billing and denial resolution of physician medical claims. In addition:

Analyze/manage EPIC accounts to determine credit source

  • Analyze accounts in DataArkGE/DataArkAllscripts to determine credit source

  • Resolve credits through generating refunds and posting adjustments in accordance with UNC-H policies and procedures while maintaining rigorous quality and productivity standards

  • Research and rework returned refunds

  • Mail refunds to various insurance carriers, payors, and patients

  • Manage Medicaid overpayments via the NC Tracks website

  • Manage Medicare overpayments via e-services (MC website)

  • Analyze charge corrected claims for correct coding/pricing

  • Analyze retro adjudicated claims for correct pricing/filing order/coding

  • Collaborate with coders, claims teams, PAU for process improvement

  • Collaborate with HB Transplant team to ensure proper posting of charges/payments for transplants

Qualifications

High School diploma or GED.

Three (3) years of experience in a clerical, accounting or customer service setting.

Six (6) months of experience working with CPT and ICD-10.

Primary Location: Chapel Hill, North Carolina, United States

Department: P-17679-UNCFP Payment Posting

Shift: Day Job