CBO Insurance Resolution Specialist

The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities within UVA Health System receives correct reimbursements from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and state requirements and also meeting the requirements of payers. The incumbent will serve as the liaison between insurance companies, patients and the departments to ensure the claims are processed and followed up to meet the CBO Revenue Cycle performance metrics & representative Facility specific goals. They will also research and answer all questions and complaints regarding patient responsibility balances and billing inquiries sent to them through the customer call center with the highest degree of courtesy and professionalism. The representative utilizes multiple electronic billing, hospital information systems and payer websites as well as the knowledge of medical billing and coding guidelines to resolve insurance denials and guarantor/patient inquiries. The representative must be able to respond knowledgeably to a wide range of billing and complex denial issues when dealing with insurance companies. The goal is to resolve all of the billing/denial issues through positive relationships/communication with the insurance companies, patients and internal customers. Performs inpatient/outpatient billing process for multiple different facility types within UVA Health that the Central Billing Office has assigned AR responsibility. Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and departmental rules. Resolves insurance billing/payments collection process through proven knowledge of revenue cycle. Performs optimum customer service to all inquiries from insurance companies. UVA Health clinical departments and patients. Performs analysis of patient accounts to insure efficient and timely adjudication. Effectively evaluates expected reimbursement and payments to insure they are processed correctly for all lines of business and facilities assigned to the CBO. Performs revenue cycle department functions to achieve department goals. In addition to the above job responsibilities, other duties may be assigned. Position Compensation Range: $16.64 - $25.79 Hourly MINIMUM REQUIREMENTS Education: High School Graduate or Equivalent Experience: 2 years of relevant experience. Licensure: None required PHYSICAL DEMANDS Job requires sitting for prolonged periods. Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly. 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, pregnancy, sexual orientation, veteran or military status, and family medical or genetic information.

Created: 2024-10-30