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Billing/Collections Specialist Rx Partners

  • Job ID: 26377887
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Community Provider Services
  • Department: Bridgeville Pharmacy
  • Location: 500 Old Pond Rd, Bridgeville PA 15017
  • Union Position: No
  • Salary Range: $17.05 to $27.07 / hour

Description

Provide for the timely control, submission, collection, and analysis of all third party payor accounts. Provide for the on-going analysis of insurance verification, billing and collection efforts to insure a timely resolution of accounts. Make sound financial decisions to facilitate the resolution of third party accounts based on the information gathered from such sources at third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Billing/Collections Specialist.

Responsibilities:
  • Assist in the development and maintenance of positive working relationships between the receivable team and nursing home facility personnel.
  • Interact with the Nursing Home personnel to ensure the cooperative flow of insurance and financial information on patients.
  • Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.
  • Communicate pertinent reimbursement issues in a timely manner to Supervisor, CEO and Nursing Home.
  • Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.
  • Observe both UPMC HS and Rx Partners-LTC policies and procedures.
  • Maintain both yourself and your work in a manner consistent with a professional environment.
  • Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.
  • Provide assistance to other department personnel as required through the direction of your supervisor.
  • Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate.
  • Adhere to Fair Debt Collection Practices Act guidelines.
  • Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, nursing home facilities and patients and/or their representatives.
  • Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.
  • Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc.
  • Pursue the collection of pharmacy accounts from the point of adjudication to the final resolution of the account.
  • Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
  • Pursue information in an aggressive, yet highly professional manner.

Qualifications

  • A Bachelor's degree; or 3-5 years experience as a retail pharmacy technician or 3-5 years experience in pharmacy accounts receivable environment
  • Strong interpersonal, communication and collection skills requiredKnowledge of all third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial, etc.), the applicable reimbursement practices and familiar with automated patient billing systems
  • History of successful third-party collection skills and decision-making capabilities, preferably in long term care or retail pharmacy
  • Ability to communicate with patients, payors, government offices, etc. through face to face, telephone and written correspondence
  • Ability to act independently in a decisive and timely manner

    Licensure, Certifications, and Clearances:
  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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       Current UPMC employees must apply in HR Direct

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