Job Description

Job Title: Account Representative
Job ID: 673861
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility:
Department: Rev Cyc Ins Collections
Location: 2 Hot Metal Street, Pittsburgh PA 15203

Description

Job Summary:

UPMC Corporate Services is hiring an Account Representative to support the Revenue Cycle Insurance Collections department during daylight hours on Monday through Friday. In this role, you will manage all fiscal functions necessary to ensure the prompt and correct payment to the hospital of all monies owed to the provider by insurers and patients.  

In doing so, you will ensure claims are submitted accurately and timely, communicate with insurance companies, patients and physicians regarding payment issues, establish reasonable payment arrangements and recommend adjustments according to UPMC policies. You will also review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts and will identify and assign appropriate status codes.

Responsibilities:
  • Demonstrate knowledge of the current functionality of the patient accounting systems.
  • Evaluate and recommend referrals to agency, law firm, Financial Assistance and Bad Debt.
  • Identify issues and submit corrective action recommendations.
  • Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials. Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
  • Manage assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards.
  • Meet quality assurance, benchmark standards and maintain productivity levels as defined by management.
  • Perform duties and job responsibilities in a fashion, which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians, and other departments within the organization.
  • Understand Third Party Billing and Collection Guidelines.
  • Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies.

Qualifications

  • High school graduate or equivalent. 
  • Hospital medical billing and collections experience is preferred. 
  • 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:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $14.12 to $22.16

Union Position: No

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