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Patient Accounting Representative II - CCP

  • Job ID: 52250354
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Children's Community Pediatrics
  • Department: Billing Office
  • Location: 11279 Perry Highway, Wexford PA 15090
  • Union Position: No
  • Salary Range: $13.94 to $21.26 / hour

Description

Children's Community Pediatrics is hiring a Full-Time Patient Accounting Representative II to help support the CCP Central Billing office in Wexford. This position will be working the weekday daylight shift, 8:00am to 4:30pm.

Purpose:

Perform all necessary billing entry and collection functions in order to maximize third-party reimbursements and to assure accurate record keeping in support of billing and collection activities.

Responsibilities:
  • Develops and maintains documentation pertaining to unpaid or rejected claims; specifically reasons for rejection, course of action taken, and final disposition of the disputed claim.
  • Remains current in knowledge of third party payment policies, procedures and reimbursement rates.
  • Initiates billing processes to assure timely submission of all patient account claims according to established billing schedules and procedures.
  • Verifies patient eligibility for coverage by their respective third-party payor
  • Processes and submits requests to appropriate third-party payers for authorization to provide homecare and hospice services, according to and in compliance with, established organizational policies and procedures; and according to payer requirements. Reviews patient record and provides additional documented supporting information needed for authorization when requested.
  • Conducts immediate and effective follow-up activities on all unpaid or rejected claims, and implements corrective action in order to permit prompt resubmission of claims for payment.
  • Prepares accounts for referral to collection agency by documenting previous attempts to collect unpaid claims. Follow-up on all accounts placed with collection agency until advised that all collection efforts have been exhausted. Prepares listing of efforts exhausted accounts to be written off to bad debt. Provide documentation of all efforts previously taken to resolve claim.
  • Investigates, interprets and responds to inquiries pertaining to accounts from patients and third-party intermediaries.

Qualifications

  • High School Diploma or equivalent.
  • Associate Degree in Accounting, Business Administration, Information Systems, or a related discipline is preferred.
  • Two years in a medical billing and / or collection capacity
  • Thorough knowledge of third-party reimbursement methodologies
  •  Advanced computer skills related to web-based applications and computerized medical billing systems
  • Thorough knowledge of medical terminology

Licensure, Certifications, and Clearances:
  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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       Current UPMC employees must apply in HR Direct

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