Are you passionate about helping kids be their best selves?

UPMC Children’s Community Pediatrics is hiring a Full-Time Billings/Collections Specialist to support the office in a hybrid role.

EPIC experience preferred.

Purpose:
Provide for the timely control, submission, collection, and analysis of all third-party payor accounts. Provide for the on-going analysis of insurance verification, billing and collection efforts to insure a timely resolution of accounts. Make sound financial decisions to facilitate the resolution of third-party accounts based on the information gathered from such sources at third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Billing/Collections Specialist.

Responsibilities:

• Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.
• Communicate pertinent reimbursement issues in a timely manner to Supervisor.
• Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc.
• Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate.
• Observe UPMC HS policies and procedures.
• Maintain both yourself and your work in a manner consistent with a professional environment.
• Provide assistance to other department personnel as required through the direction of your supervisor.
• Pursue information in an aggressive, yet highly professional manner.
• Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.
• Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.
• Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.
• Pursue the collection of accounts from the point of adjudication to the final resolution of the account.
• Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers and patients and/or their representatives.
• Interact with office personnel to ensure the cooperative flow of insurance and financial information on patients.
• Adhere to Fair Debt Collection Practices Act guidelines.
• Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
• Assist in the development and maintenance of positive working relationships between the receivable team and clinical office personnel.