CBO Insurance Resolution Specialist

UOVUNIUSR0078485EXTERNALENUS 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.

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 starting base rate for this role is $17.66 hourly. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Paid Time Off, Long-term and Short-term Disability, Retirement Savings

• Health Saving Plans, and Flexible Spending Accounts

• Certification and education support

• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment.