Description

Purpose:
Ensures that the Collections and Financial Counseling functions in Credit and Collections are performed efficiently and timely. Understands all functions with the team and is able to fill in any role if needed. Serves as primary contact for the rest the team when any questions or problems arise.

Responsibilities:

• Mail out financial aid applications per requests from patients, doctor's offices or other departments
• Call doctor's offices to determine if surgeries are urgent. If the patient cannot pay or has no insurance it may be decided, with input from the physician, that the procedure could be cancelled
• Document notes on encounters
• Post payments collected and send receipts
• Visit in-house patients in their rooms when the request is received from nursing or the patient's request to speak to someone regarding billing
• Assist walk-in patients with questions, financial aid, billing or taking payments and giving receipts
• Call doctors' offices for procedure codes or additional information needed to calculate out of pocket expenses
• Call insurance companies and use web sites to verify eligibility and obtain the benefits and out of pocket information
• Take calls from patients and physician offices to give price estimates and/or run thru estimation tool to give estimate due for out of pocket liability
• When estimates are not calculated by estimator tool use CPT, CDM, contract rates, benefits from payor websites and reports to calculate the estimated price and patient?s financial responsibility
• Work the pre-registration report to calculate surgery cases and call the patient to collect monies due
• Work the pre-registration report of diagnostic services and make calls to collect on monies due for pre-scheduled encounters
• Use estimator tool daily to calculate estimated patient liability
• Conducts a financial interview with self-pay patients to determine the patient?s ability to pay
• Assists in responding to patient, Attorney General and attorney letters.
• Prepares Month End Closing for Collections area.
• Under the direction of the Supervisor, writes and updates procedures and policies for the staff.
• Under the direction of the Supervisor, monitors workflow and staffing to ensure production is maintained.
• Under the direction of the Supervisor, coordinates all training and cross training of Financial Counselors/Collectors.
• Must be knowledgeable in billing regulations for third party payors.
• Monitors Financial Counselor productivity and makes the Supervisor aware of any staff not meeting expectations.
• Monitors pricing in the Estimation Tool and works with Advisors to resolve price discrepancies and benefit discrepancies.
• Resolves questions from staff on a daily basis. Reports problem areas to the Supervisor and helps to find resolution.
• Serves as the senior level for resolution in solving patient problems and issues requiring additional oversight.
• Performs other duties or special projects as assigned by the Supervisor.
• Performs other duties or special projects as assigned by the Supervisor.
• Performs some supervisory duties in Supervisor?s absence, i.e., reviewing time sheets.
• Use Cyracom phone or Interpreter Service to be able to communicate with patients who do not speak English
• Contact the Financial Aid Rep for status of financial aid application and to find out if any additional information is needed then contact the patient when necessary
• When a cash payment is made a deposit slip is prepared and put in the safe for courier pick-up
• Contact scheduling department with questions regarding services or to have insurance information verified and updated on accounts
• Communicate with Patient Registration and departments when a patient is to pay at the time of service

Qualifications

Required Knowledge, Skills and Abilities:

• High school graduate.
• Two years' experience in customer service, collections, call center or in a hospital or physician office setting. Proficient computer and typing skills.
•  Good analytical, problem solving, decision-making skills, and inter-personal communication skills are essential. Ability to understand and apply payor contract terms when calculating patient liability.
• Telephone Etiquette and understanding of HIPAA compliance. Prior use of Microsoft Office applications recommended, especially the use of Excel and Word.

Preferred Knowledge, Skills and Abilities:

• Associate degree preferred. Supervisory experience helpful. Collections experience preferred.
• Additional knowledge relating to hospital registration systems and processes. Familiarity and competence on one or multiple billing and patient accounting systems.
• Understanding of CPT/HCPCS codes and familiarity with a hospital Charge Description Master ICD9/ICD10 coding knowledge.
• Ability to access and use various computer applications and web sites needed to perform daily tasks.

Licensure, Certifications, and Clearances:

• Act 34 with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran

Individuals hired into this role must comply with UPMC’s COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.
 
 

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