Job Description

Job Title: Account Representative
Job ID: 616478
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day
Facility: UPMC Community Provider Svcs
Department: Billing
Location: 215 Beecham Drive, Pittsburgh PA 15205

Description

Are you looking for a challenge with a growing department? This position will manage all fiscal functions necessary to ensure the prompt and correct payment to In-Home Services Billing Department of all monies owed by both insurers and patients. Ensure claims are submitted accurately and timely, communicate with insurance companies and patients regarding payment issues, establish reasonable payment arrangements and recommend adjustments according to UPMC policies. Review the post and balance payment/denial and adjustment transactions necessary for closing accounts. Identify and assign appropriate status codes.

Responsibilities:
  • Adhere to the UPMC Health System and UPMC In-Home Services Standards of Conduct.
  • Answer billing and insurance inquiries on patient accounts from patients, insurance companies and other In-Home Services billing areas.
  • Attend compliance training as defined in the compliance training policy.
  • Create and maintain Excel spreadsheets to report daily, weekly or monthly activity of cash, billing and collection status.
  • Develop skills relevant to position through Continuing Education and Employee Training and Development.
  • Identify and document overdue patient accounts to be sent to collections.
  • Identify and post cash to correct patient accounts. All unidentified cash is resolved in a timely manner.
  • Mail private pay statements to patients and performs necessary follow-up and investigative work as required.
  • Maintain both self and work area in a manner consistent with a professional environment.
  • Maintain daily cash transactions for bad debt.
  • Maintain, correct and reconcile batch posting for any or all payors as requested by the Supervisor.
  • Post, reconcile, mail and file all refunds that are created.
  • Prepare adjustments that are necessary to change existing accounts receivable for patient information for patients.
  • Prepare all cash, claim and related backup documentation for filing and/or storage.
  • Prepare custom billing statements for special accounts and/or institutional billing, as required. Perform collection on these accounts as required.
  • Prepare or obtain documents necessary for claim submission.
  • Provide assistance on special tasks as requested by Manager or Supervisor of Business Office.
  • Reconcile lockbox to the daily deposits.
  • Refrain from disclosing or revealing confidential information to any person, except as specifically necessary for the staff member to perform his or her job duties. Refrain from access patient or coworker records (either electronic of files) except as specifically necessary for the staff member to perform his or her job duties.
  • Research patient accounts that are effected by overpayments and refunds, payer or patient, as required.
  • Review billing edit report to identify and perform data edits needed to ensure that claims are submitted to the correct payer and that all required information is included.
  • Review unpaid accounts by examining remittance advice and aging reports. Investigate and take action on unpaid accounts to bring them to closure.
  • Submit claims to appropriate insurance carriers or organizations to obtain payment for equipment and/or service provided. Perform collection on these accounts as required.
  • Utilize billing software to confirm orders for billing.

Qualifications

  • High school diploma or equivalent. 
  • Excellent interpersonal, organizational, communication and effective problem solving skills are necessary. 
  • Ability to communicate with patients, payors, outside agencies, and general public through telephone, electronic and written correspondence. 
  • Working experience on personal computers, electronic calculators and various office equipment is needed. 
  • Collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred. 
  • Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial.

Licensure, Certifications, and Clearances:
  • Act 34 Criminal Clearance

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $13.64 to $21.41

Union Position: No

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

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