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Job Description

Job Title: Payor Specialist
Job ID: 640824639
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Pinnacle Hospitals
Department: Outcomes Management
Location: 111 South Front Street, Harrisburg PA 17105

Description

Our team is growing and we have a variety of opportunities available for Payor Specialist. If you’re passionate about being an integral part of a team and looking for a career that offers great benefits and plenty of room for growth, we invite you to explore this opportunity today!

This position must be able to work the following schedule: Monday through Friday, 9:00 a.m. to 5:30 p.m. or 10:00 a.m. to 6:00 p.m. and includes weekends.

Responsibilities:
  • Assist in notification to payors of admissions/discharges.
  • Assist in communicating payor issues and concerns regarding level of care, continue stay, denials and discharge plans to care managers as appropriate.
  • Support the denial management processes, specifically concurrent and retrospective denials, and appeals.
  • 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.
  • Participate in yearly continuing education programs to include fire, safety, disaster and Universal Precautions.
  • Assist in obtaining payor benefit verification for post-acute services when requested.
  • Effectively support payer call center as it relates to obtaining authorization for the appropriate level of care.
  • 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.

Qualifications

  • High School diploma required. 
  • 3-5 years of secretarial experience preferably in a health care setting demonstrating increasing responsibility required. 
  • 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:
Clearances must be dated within 90 days

  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

    Salary Range: $13.97 to $22.37 / hour

    Union Position: No

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