UNC Health Care CLAIMS CODING SPECIALIST - UNCFP PAYMENT POSTING in Chapel Hill, North Carolina
CLAIMS CODING SPECIALIST - UNCFP PAYMENT POSTING
Job ID: OTH01MV1
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
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