Description

UPMC is hiring a Charge Processing Specialist to support their Infectious Disease practice located in Shadyside with 4 Physicians and 2 Advance Practice Providers. This position will work Monday through Friday 7:30am to 4pm. 

Responsibilities

* Billing, answering phone, some appointment scheduling, scanning.

*Performs in accordance with system-wide competencies/behaviors.

*Performs other duties as assigned.

Assist in the development of the charge processing manuals for each location.

Assure the processing of the clinical charges is entered in order of their clinical significance to maximize reimbursement.

Balance charges entered at the end of each day.

Coordinate the exchange of information/documentation with other practice plans or ancillary departments.

Document all medical records, which are attached to the charge document, with the date of entry and forward to the Billing Department on a daily basis.

Document all problem charges with date charge was unable to be processed, what specific information is missing, and the user initials and forward to Charge Processing Analyst for resolution.

Ensure Managed Care requirements are met by accessing the referral system and attaching the pre-loaded authorization to the charge being processed. Direct entry of the Managed Care referral into Cadence will be required if the authorization is attached to the charge document upon submission to the Charge Processing Department.

Ensure physician charges are applied to the correct patient account by verifying information indicated on charge document against system information.

Ensure the appropriate modifier is attached at the charge entry level for Medicare non-covered and limited coverage service and for resident participation.

Ensure the charges for bilateral services are processed in accordance with payer specific guidelines.

Perform limited ICD-9 and CPT-4 coding from charge slips, encounter forms, or source documentation.

Process charge documents in the Epic system and maintain minimum productivity levels.

Review coding and charges for accuracy and completeness.

Verify all charge batches entered are processed with the correct revenue location.

Verify the appropriate Place of Service (POS) code is submitted in relation to the rendered procedure Type of Service (TOS) at the charge entry level based on payer specific requirements. The UPP Billing and Coding Departments will supply these payer specific requirements.

Qualifications

Qualifications - Internal

• High school diploma.
• 2 years experience in registration, scheduling, insurance verification, and charge and payment posting processes within a physician office practice preferred. 
• Strong verbal, telephone and written correspondence skills. 
• Knowledgeable of medical terminology, cash collection and application, ICD-9/CPT-4 coding, and third party payor billing and reimbursement practices.
•   Ability to effectively problem solve.  Prior working experience on personal computers and various office equipment.

Licensure, Certifications, and Clearances:

• Act 34

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.  

UPMC has a Center for Engagement and Inclusion that is charged with executing leading-edge and next-generation diversity strategies to advance the organization’s diversity management capability and its national presence as a diversity leader. This includes having Employee Resource Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Differences) Network, which support the implementation of our diversity strategy.

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Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.