Job Description

Job Title: Contact Center Specialist I
Job ID: 1800007E
Status:
Regular/Temporary: Regular
Hours:
Shift: Variable
Facility:
Department: Rev Cyc Contact Ctr
Location: 2 Hot Metal Street, Pittsburgh PA 15203

Description

Job Summary


Do you have experience handling inbound and outbound calls?  If so, apply to take the next step in your career! UPMC Corporate Services is hiring both full-time and part-time Contact Center Specialist I's to help support various departments at the Quantum One building in the South Side. The days and hours for these positions will vary. Available shifts include daylight, evening, and weekend hours. 


A great perk includes work from home options, which become available based on employee performance, usually within six months of hire! 


In this role, you will serve as the first line of contact for the patient. The Contact Center Specialist I acts as an advocate for patients by providing guidance, interpretation and education on scheduling, registration, billing, claim status, and various customer related inquires.  If you are enthusiastic about assisting others in a customer service role and think you are up for the challenge, apply online today!


Responsibilities:

  • Answer multi-line telephone system and schedule appointments, contact or page physicians according to department questionnaires, protocols and templates.
  • Complete follow-up on unpaid account balances. Contact guarantors, third party payors, and/or other outside agencies for payment of balances due.
  • Contact patients to discuss their post-discharge appointment requirements; follow up and coordinate all appointments for the patient.
  • Demonstrate ability to understand reason for patient visit and apply decision making ability to schedule an appointment with the correct sub-specialist by obtaining medical information/diagnosis in order to adequately meet the patient's needs and allow for appropriate scheduling to a specific physician or specialty.
  • Demonstrate the ability to understand the reason for a consumer referral call. Use decision making ability to appropriately refer a physician, class or program to meet the consumer's needs.
  • Demonstrate the ability to understand the reason/needs for the patient or clinicians call and apply the decision making ability to page or contact the appropriate physician to meet the patient's needs.
  • Document all actions taken on a patient account. Review on-line account history and EOB's to ensure all payers have been billed and to validate the accuracy of payments and adjustments posted.
  • Ensure effective communication and call escalation to appropriate personnel; includes thorough and accurate documentation of telephone encounter.
  • Ensure effective communication to patients regarding scheduling and call details, give basic information to patients (directions, parking information, and required preparation for appointment).
  • Establish reasonable payment plans according to department policies; set up payment arrangement in system and monitors payments for consistency and timeliness. Counsel patients on various local, state and federal agencies, which may be available to assist with funding of health care.
  • Identify and take action towards resolution of problematic accounts through potential refunds, adjustments, payment transfers, etc. to bring balance to zero. Adhere to Fair Debt Collection Practices Guidelines and understands the laws and regulations applicable to job functions.
  • Identify, review, and research credit balance accounts, potential refunds, adjustments, payment transfers, etc., to bring the account balance to zero.
  • Maintain performance at or above established benchmarks for: Quality Assurance. Average Call Handling Time, Schedule Adherence and Telephone Aux usage.
  • Provide support to supervisor/manager in the instruction of training new staff in order to maintain a high quality of service to the patient and the department.
  • Research, resolve and respond to email, web and telephone billing inquiries from patients and insurance carriers in accordance with departmental protocols.
  • Review and take action on accounts on aged trial balance reports or in assigned work queue meeting specified dollar and age criteria to ensure lowest number of days possible on accounts receivable. Assign accounts deemed un-collectible to external collection agencies on a monthly basis.
  • Review, verify and enter the patient's demographic and insurance information to ensure data integrity. Answer multi-line telephone system and schedule appointments, contact or page physicians according to department questionnaires, protocols and templates. Understand UPMC 72-hour appointment requirement and work to ensure guidelines are met while still placing the patient with the right sub-specialist whenever possible to avoid return visit to see the correct sub-specialist.

Qualifications

  • High school graduate or equivalent. 
  • Two years customer service experience or call center experience required OR one year health insurance call center and claims adjustments experience required is required. 
  • Prior phone or call center experience is preferred.
  • Advanced knowledge of health insurance, third party payor billing requirements, medical terminology and reimbursement practices preferred. 
  • Must be able to maintain confidential information. 
  • Competent in MS Office/PC skills 
  • Must be able to make appropriate decisions based on the circumstances as well as established protocols. 
  • Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.

Licensure, Certifications, and Clearances:
  • Act 34 Criminal Clearance
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

 

Salary Range: $14.53 to $22.86

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

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.



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