Job Description

Job Title: Supervisor, Reimbursement
Job ID: 708865
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Community Provider Svcs
Department: Specialty Reimbursement
Location: 215 Beecham Drive, Pittsburgh PA 15205

Description

Purpose:
Responsible for training, updating reimbursement processes / SOP's and policies, and monitoring the performance of the branch Insurance Verification, Reimbursement Assistant, and ship order staff.

Responsibilities:
  • Acts as a resource to all branch personnel to resolve questions concerning reimbursement.
  • Ensure patient benefits, OOP, copays are communicated, documented, and mailed to patient timely and accurately.
  • Ensures accurate and current billing documentation is maintained. i.e., AOB, DIF, Financial Responsibility Letter
  • Ensures company pricing and discount policies are administered, communicated and documented correctly.
  • Ensures initial data entry into Patient Care Management system is specific and accurate i.e., Brand vs. Generic, attaching auth. to correct service, and entering of responsibilities.
  • Ensures re-verification of benefits occurs timely and is documented clearly in medical record.
  • Monitors the performance and compliance of reporting personnel and provides feedback via performance evaluations and disciplinary action when necessary.
  • Provides updates to IVC, Reimbursement Assistants, and Ship Order personnel regarding changes in contracts/internal processes.
  • Recruits, hires, trains and supervises a competent Insurance Verification, Reimbursement Assistant, and Ship Order Staff in all aspects of the incumbent job responsibilities.

Qualifications

  • High school graduate or equivalent, Bachelors degree preferred. 
  • Minimum of 3 years staff supervisory experience in a professional billing environment or other health care environment preferred. 
  • Must be knowledgeable of medical terminology, electronic and manual claims processing, and third party payor billing guidelines and reimbursement practices for multiple specialties. 
  • Must be able to establish priorities, effectively problem solve, and use good judgment and decision making in day-to-day billing operations.
  • Requires prior working experience on personal computers and various office equipment.

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

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

Salary Range: $22.60 to $39.11

Union Position: No

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