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Department: 480502 - HR UTS/UNC Partnership

Location: Chapel Hill, NC

Essential Job Duties:

This Insurance Specialist position performs both dental and medical insurance services for the department. The Insurance Specialist position works in all areas of billing and reimbursement from private dental insurance companies as well as Managed Care companies. This position requires specialized knowledge of the insurance industry standards relating to billing and reimbursement in order to perform position duties and a strong understanding of accounts receivable. This position works closely with private insurance carriers, particularly those contracting with the clinics. The position also requires an extensive and detailed understanding of dental and medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing and of insurance policies and contracts for multiple insurance vendors.

Other Work/Responsibilities:

Job Duties:

The duties of this position include filing dental insurance claims and pre-treatment estimates for privately insured patients; obtaining and providing the clinical documentation necessary for claims processing, i.e. x-rays, chart notes and letters of necessity; investigating certain denied claims, following-up on those investigations and submitting claims appeals for those denied claims; scanning of such documentation in the electronic patient record as insurance cards, insurance explanation of payment, provider narratives and insurance consent and regularly auditing patient records for accuracy and completion of billing, coding, and clinical documentation. This position answers questions from patients and providers regarding dental insurance benefits, claim status and account summary, as well as assisting patients with in-house payment arrangements under the policies of the school advising patient of their options. This position requires HIPAA compliance.

Required Qualifications:

Required Skills:

• Ability to file dental insurance claims and pre-treatment estimates for privately insured patients;

• Ability to obtain the clinical documentation necessary for claims processing, i.e. x-rays, chart notes and letters of necessity; investigating certain denied claims, following-up on those investigations and submitting claims appeals for those denied claims

• Ability to properly scan such documentation in the electronic patient record as insurance cards, insurance explanation of payment, provider narratives, and insurance consent

• Ability to provide exceptional customer service to all visitors and guests of the dental office

Preferred Qualifications:

N/A

Required license or certification:

N/A

Position Number: 48CK04

AA/EEO Statement:

NC State University is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, age, sexual orientation, genetic information, status as an individual with a disability, or status as a protected veteran.

If you have general questions about the application process, you may contact Human Resources at (919) 515-2135 or workatncstate@ncsu.edu. Individuals with disabilities requiring disability-related accommodations in the application and interview process, please call 919-515-3148.

Final candidates are subject to criminal & sex offender background checks. Some vacancies also require credit or motor vehicle checks. If highest degree is from an institution outside of the U.S., final candidates are required to have their degree equivalency verified at www.wes.org or equivalent service. Degree(s) must be obtained prior to start date in order to meet qualifications and receive credit.

NC State University participates in E-Verify. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States.