Current UPMC employees must apply in HR Direct.

Patient Access Specialist II

Job ID: 7841116256
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Work Arrangement: On-siteWork Arrangement information
Facility: UPMC Presbyterian
Department: OP Rheumatology
Location: 3601 Fifth Avenue, Pittsburgh, PA
Union Position: No
Salary Range: $ 20.0-30.55 USD

Purpose:
Typically, functions under the direction of the Supervisor/Manager responsible for patient access. Schedule appointments for different departments, specialties, subspecialties and/or large divisions at multiple locations or centers. Serve as front line resource for PSD Departments to manage access of external public to our care providers and ensures goals of 72 hours patient access are met while making the appropriate appointment with the right sub specialist at the right location so the patient needs are met with the first visit whenever possible.

Responsibilities:
 

  • Make decisions independently and take initiative to find answers to questions. Appropriately triage phone calls to or from clinical and other areas.
  • Ensure effective communication and call escalation to appropriate personnel; includes thorough and accurate documentation of telephone encounter.
  • Research, resolve and respond to email, web and telephone billing inquiries from patients and insurance carriers in accordance with departmental protocols.
  • Maintain performance at or above established benchmarks for: Quality Assurance. Average Call Handling Time, Schedule Adherence and Telephone Aux usage.
  • 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.
  • Ensure effective communication to patients regarding scheduling and call details, give basic information to patients (directions, parking information, and required preparation for appointment).
  • 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.
  • Review, verify and enter the patient’s demographic and insurance information to ensure data integrity.
  • 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.
  • Answer multi-line telephone system and schedule appointments, contact or page physicians according to department questionnaires, protocols and templates.
  • 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.
  • 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:

Completion of high school diploma or equivalent and 2 years of medical office, customer service, inbound call center (preferred) or other relevant health care experience required. Associates degree and 1 year of medical office, customer service, inbound call center (preferred) or other relevant health care experience preferred. Must have working knowledge of Word and Outlook. Working knowledge of Excel is preferred. Advanced knowledge of health insurance preferred. Initiative to work productively in a team setting with minimal supervision. Must be able to multitask at a high level. Must be able to learn new concepts quickly and apply them in a medical setting. Experience with/knowledge of medical terminology and multi-line telephone systems is preferred. Must be able to maintain confidential information. Ability to interact with a variety of external and internal constituents, including patients, patients’ families, internal physicians, referring physicians or their clinical/office staff, insurance companies, nurses. Electronic scheduling system experience is preferred. Must be able to make appropriate decisions based on the circumstances as well as established protocols. Must be able to learn and apply third party payer guidelines and reimbursement practices and available financial resources for the funding of medical care. Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances. Must demonstrate the ability to effectively problem solve and make independent decisions.

Licensure, Certifications, and Clearances:
 

  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

CAREER GROWTH

Grow Your Nursing Career

Spanning over 20 clinical specialties and more than 50 unique nursing roles, every nurse at UPMC can achieve and advance their goals with the My Nursing Career Ladder. Whether you’re looking to progress to an elevated role or continue your education, UPMC equips nurses with the resources, feedback, leadership, and benefits to help you succeed and achieve your career goals. Here’s how a few nurses have grown their careers through the years at UPMC:

Clyde C.

As a Professional Staff Nurse, Expert at UPMC Muncy, Clyde is a great example of someone who has taken advantage of UPMC’s My Nursing Career Ladder to grow his career while remaining in the same hospital location.

Clyde’s Career Journey:

⦁ 2017: Professional Staff Nurse – UPMC Muncy
⦁ 2021: Sr. Professional Staff Nurse – UPMC Muncy
⦁ 2022: Sr. Professional Staff Nurse II – UPMC Muncy
⦁ 2022-present: Professional Staff Nurse, Expert – UPMC Muncy

Male nurse stands in front of hospital, smiling at the camera.

Michelle B.

In her current role as a Professional Staff Nurse, Expert at UPMC Presbyterian, Michelle cares for patients with chronic and ongoing health issues as part of a Medical-Surgical unit. Michelle enjoys the daily change that Med-Surg nursing brings, and has found a career path that is interesting, meaningful, and full of opportunity.

Michelle’s Career Journey:

⦁ 2019: Staff Nurse – UPMC Presbyterian
⦁ 2020: Professional Staff Nurse – UPMC Presbyterian
⦁ 2021: Professional Staff Nurse, BSN – UPMC Presbyterian
⦁ 2021: Sr. Professional Staff Nurse, BSN – UPMC Presbyterian
⦁ 2022: Sr. Professional Staff Nurse II, BSN – UPMC Presbyterian
⦁ 2023: Professional Staff Nurse, BSN, Expert – UPMC Presbyterian

Michelle, a blonde nurse, smiles at the camera outside of a hospital setting.

INSURANCE SERVICES DIVISION OF UPMC

Advance Your Future

A career with UPMC means more than just caring for patients – when you’re a part of UPMC Insurance Services Division, it means caring for more than four million insurance members, too. UPMC Insurance Services Division offers a full range of health insurance products and services to our network across the country, providing peace of mind, better health, and financial security to our members, along with limitless career opportunities and a rewarding mission to those on our team.

About UPMC Insurance Services Division

As an integrated health care provider-insurer, UPMC goes beyond patient care to provide insurance products and services to millions of members. Our team partners with UPMC and community network providers to deliver knowledge and expertise that provides the highest quality care at the most affordable price, supporting our members through service, communication, and more.

Fast Facts:

  • We provide insurance products and services to over more than four million members.
  • UPMC’s Insurance Services Division offers a full range of health insurance options including UPMC Health Plan, Workpartners, UPMC for Life, UPMC for You, UPMC for Kids, UPMC Community HealthChoices, and Community Care Behavioral Health.
  • UPMC Health Plan is among the nation’s fastest-growing health plans.

Opportunities on Our Team

We’ve got a job that’s just right for you! UPMC Insurance Services Division team offers a vast array of career paths and opportunities, from career areas like customer service, data analytics, and information technology and even patient care roles like social work, nursing, and care management.

Whether in non-clinical or patient-facing roles, our team impacts patients and members by providing quality experiences before, during, and after their care, building relationships in a unique and meaningful way.

Recognized for Excellence

Be a part of an award-winning team! UPMC Insurance Services Division has been recognized for outstanding care and service with awards that include:

  1. U.S. News and World Report named UPMC for Life a “Best Insurance Company for Medicare Advantage” in Pennsylvania for 2024.
  2. The Human Rights Campaign Foundation has named UPMC Health Plan an “Equality 100 Leader in LGBTQ+ Workplace Inclusion” for 2023–2024.
  3. UPMC for Life ranked #1 in Customer Satisfaction* among Medicare Advantage Plans in Pennsylvania by J.D. Power.
  4. The Ethisphere Institute named UPMC as one of the World’s Most Ethical Companies for the sixth consecutive year.

*Results are based on award-eligible plans in Pennsylvania by J.D. Power. For J.D. Power 2024 award information visit, jdpower.com/awards.

Jump-Start Your Career

Looking to launch a career with longevity and opportunity? With countless entry-level opportunities for recent graduates, along with tools and resources that empower you as you learn and grow, UPMC Insurance Services Division is the perfect place to get a career started.

Interested in taking your career to new heights? Our career paths and advancement opportunities will provide you with chances to achieve your goals at every step.

BENEFITS AND LIFE AT UPMC

Why Work Here

We know that you have many options when choosing where to build your career. So why choose UPMC? We can think of a few reasons.

Work-Life Balance

Finding the ideal balance to manage the important elements in your life.

Development & Opportunities

Enhancing your career through continued learning opportunities and/or advancement.

Compensation

Receiving competitive pay for the work that you do – base pay, merit, and premium pay.

Performance & Recognition

Rewarding performance that supports the goals and mission of UPMC.

Benefits

Providing assistance and security to meet the current and future needs of you and your family.

Work-Life Balance

Finding the ideal balance to manage the important elements in your life.

Development & Opportunities

Enhancing your career through continued learning opportunities and/or advancement.

Compensation

Receiving competitive pay for the work that you do – base pay, merit, and premium pay.

Performance & Recognition

Rewarding performance that supports the goals and mission of UPMC.

Benefits

Providing assistance and security to meet the current and future needs of you and your family.

Benefits that Matter to You

We’re committed to providing benefits that meet your needs and support your well-being in all areas of life.

  • Earn over 5 weeks of paid time off every year
  • Affordable medical, dental & vision coverage
  • Student loan assistance and tuition reimbursement options
  • Earn up to 8% of your eligible pay in retirement contributions from UPMC
  • Employer-paid life insurance

Benefits that Matter to You

We’re committed to providing benefits that meet your needs and support your well-being in all areas of life.

  • Earn over 5 weeks of paid time off every year
  • Affordable medical, dental & vision coverage
  • Student loan assistance and tuition reimbursement options
  • Earn up to 8% of your eligible pay in retirement contributions from UPMC
  • Employer-paid life insurance

Benefits that Matter to You

We’re committed to providing our employees with benefits that meet their needs and support their well-being in all areas of life.

  • Earn over 5 weeks of paid time off every year
  • Affordable medical, dental & vision coverage
  • Student loan assistance and tuition reimbursement options
  • Earn up to 8% of your eligible pay in retirement contributions from UPMC
  • Employer-paid life insurance

Support for You – and Your Family

Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family.

  • Two weeks of paid parental leave
  • Family planning resources
  • Tuition assistance for dependents
  • Comprehensive health care for dependents
  • Emergency child and elder care options
  • Flexible work arrangements

Support for You – and Your Family

Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family.

  • Two weeks of paid parental leave
  • Family planning resources
  • Tuition assistance for dependents
  • Comprehensive health care for dependents
  • Emergency child and elder care options
  • Flexible work arrangements

Support for You – and Your Family

Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family.

  • Flexibility to choose the shifts and work arrangements that work best for your lifestyle
  • Two weeks of paid parental leave
  • Family planning resources
  • Comprehensive health care for dependents
  • Emergency child and elder care options

A Culture That Cares

At UPMC, you can find a home among people who share your passions and care about who you are.

A Culture That Cares

At UPMC, you can find a home among people who share your passions and care about who you are.

A Culture That Cares

UPMC is a place where you can find a home, no matter your gender, race, sexual orientation, age, or culture, and where you can meet people who share your passions and care about you.

Tools to Reach Your Potential

Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams.

  • Up to $6,000 of annual tuition assistance
  • Ongoing learning via LinkedIn Learning
  • Accelerated career pathways for growth
  • Robust instructor-led education and learning pathways

Tools to Reach Your Potential

Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams.

  • Up to $6,000 of annual tuition assistance
  • Ongoing learning via LinkedIn Learning
  • Accelerated career pathways for growth
  • Robust instructor-led education and learning pathways

Tools to Reach Your Potential

Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams.

  • Unlimited educational possibilities, including no-cost BSN and MSN programs
  • Robust career ladders for every nurse – no matter your specialty, location, or career stage
  • Up to $6,000 of annual tuition assistance
  • Ongoing learning opportunities

Expansive Opportunity

Where do you want to go with your career? Wherever it is, UPMC can take you there.

Expansive Opportunity

Where do you want to go with your career? Wherever it is, UPMC can take you there.

Expansive Opportunity

Where do you want to go with your career? Wherever it is, UPMC can take you there.

* Note: Benefits described may not be applicable to all staff.

Read More about Nursing at UPMC

Kendra wears blue scrubs at a hospital desk, looks at camera with a soft smile on her face.

After working as a nursing assistant for 16 years, Kendra took the leap to go back to nursing school and become an RN.

Collage of four photos of medical-surgical nurses, all smiling.

We asked our nurses to shed some light on what Med-Surg nursing means to them. Get to know Med-Surg nursing – in four words – from UPMC nurses!

Collage of four photos of medical-surgical nurses, all smiling.

Starting her career in Environmental Services, Leah shares how she fell in love with health care and became a nurse.

Read More about UPMC Insurance Services Division

Collage of four photos of medical-surgical nurses, all smiling.

In UPMC Insurance Services Division, analysts work to understand, innovate, and improve the products and services UPMC provides.

Young man smiles at camera in a studio setting.

Eddie S. shares how his passion for football, fishing, and friendship shapes his life and his career with UPMC Health Plan.

Veteran outside hiking.

We asked our nurses to shed some light on what Med-Surg nursing means to them. Get to know Med-Surg nursing – in four words – from UPMC nurses!

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Get the Inside Scoop

Curious about the culture, roles, and people here at UPMC? The UPMC Careers blog is a great place to read more employee stories, get career tips, and learn about the passions and perspectives of folks who make up our UPMC team.

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