Job Description

Job Title: Payor Specialist
Job ID: 675368
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility:
Department: Rev Cyc Care Mgmt
Location: 2 Hot Metal Street, Pittsburgh PA 15203

Description

Job Summary:

Do you have a background in dealing with insurance companies as well as medical records? Are you interested in a career that offers plenty of room for growth. Join our team at UPMC Corporate Services! We are hiring a Payor Specialist to support the Revenue Cycle Care Management team by performing a variety of clerical, secretarial and payor related functions.The position works during business hours on Monday through Friday. 

Responsibilities:
  • Assist in communicating payor issues and concerns regarding level of care, continue stay, denials and discharge plans to care managers as appropriate and documents interactions in Canopy.
  • Assist in notification to payors of admissions/discharges.
  • Assist in obtaining payor benefit verification for post-acute services when requested.
  • Assist in prompt payor feedback to care managers/social workers enabling them to re-evaluate/re-direct the current patient plan of care in order to streamline the delivery of service.
  • Effectively support payer call center as it relates to obtaining authorization for the appropriate level of care.
  • Enter and maintain authorization/certification information in Canopy and Medipac System as it is obtained.
  • Participate in yearly continuing education programs to include fire, safety, disaster and Universal Precautions.
  • Support and adhere to the hospital's and the department's policies and procedures, philosophy and mission applying Service Excellence attitudes and behaviors in the process of performing all job responsibilities.
  • Support the denial management processes, specifically concurrent and retrospective denials, and appeals.

Qualifications

  • High School diploma required.
  • Three to five years of secretarial experience, preferably in a health care setting, demonstrating increasing responsibility required. 
  • Prior experience dealing with multiple insurances and medical records is preferred. 
  • Excellent communication skills, both written and verbal. 
  • Coordination and interpersonal skills along with the ability to exercise independent judgment. 
  • Thorough knowledge of Microsoft Work, Excel, Access and PowerPoint is required.

Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $14.53 to $22.86

Union Position: No

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