Job Description

Job Title: Contact Center Specialist I
Job ID: 727380
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility:
Department: MULTI Tri Rivers Admin
Location: 7500 Brooktree Road, Wexford PA 15090

Description

Job Summary:

Do you have experience handling inbound and outbound calls? If so, apply to take the next step in your career! UPMC Multispeciality Group within Wexford is a full-time Contact Center Specialist I's to help support our scheduling line. The position will work Monday through Friday 8:00 AM to 4:30 PM.

In this role, you will serve as the first line of contact for the patient. The Contact Center Specialist I acts as an advocate for patients by providing guidance and scheduling needs. If you are enthusiastic about assisting others in a customer service role and think you are up for the challenge, apply online today!

Responsibilities:
  • Scheduling appointments in adherence to provider protocols.
  • Adhere to language of access protocols.
  • Complete follow-up on unpaid account balances. Contact guarantors, third party payors, and/or other outside agencies for payment of balances due.
  • Contact patients to discuss their post-discharge appointment requirements; follow up and coordinate all appointments for the patient.
  • 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.
  • 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.
  • Document all actions taken on a patient account. Review on-line account history and EOB's to ensure all payers have been billed and to validate the accuracy of payments and adjustments posted.
  • Establish reasonable payment plans according to department policies; set up payment arrangement in system and monitors payments for consistency and timeliness. Counsel patients on various local, state and federal agencies, which may be available to assist with funding of health care.
  • Identify and take action towards resolution of problematic accounts through potential refunds, adjustments, payment transfers, etc. to bring balance to zero. Adhere to Fair Debt Collection Practices Guidelines and understands the laws and regulations applicable to job functions.
  • Identify, review, and research credit balance accounts, potential refunds, adjustments, payment transfers, etc., to bring the account balance to zero.
  • Research, resolve and respond to email, web and telephone billing inquiries from patients and insurance carriers in accordance with departmental protocols.
  • Review and take action on accounts on aged trial balance reports or in assigned work queue meeting specified dollar and age criteria to ensure lowest number of days possible on accounts receivable. Assign accounts deemed un-collectible to external collection agencies on a monthly basis.
  • Review, verify and enter the patient's demographic and insurance information to ensure data integrity. Answer multi-line telephone system and schedule appointments, contact or page physicians according to department questionnaires, protocols and templates. 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

  • High school graduate or equivalent. 
  • Two years customer service experience or call center experience required. OR one year health insurance call center and claims adjustments experience required. Detail Oriented. 
  • Advanced knowledge of health insurance, third party payor billing requirements, medical terminology and reimbursement practices preferred. 
  • Must be able to maintain confidential information. 
  • Excellent organizational, interpersonal and communication skills. 
  • Competent in MS Office/PC skills.
  • Must be able to make appropriate decisions based on the circumstances as well as established protocols. 
  • Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.

Licensure, Certifications, and Clearances:
  • Act 34 Criminal Clearance

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $13.60 to $20.31

Union Position: No

Apply Current Employee?

UPMC VALUES

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

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DIGNITY & RESPECT
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