At UPMC, we are committed to keeping our community safe and healthy as the COVID-19 pandemic unfolds. As our team continues to provide Life Changing Medicine to our patients, our recruiters will continue to fill positions throughout this time. Interviews and other processes may be modified to protect the safety of our candidates and employees. Thank you for your patience.

For more information about UPMC's response to COVID-19, please visit upmc.com/coronavirus.

UPMC Life Changing Medicine
Search Our Jobs

   Current UPMC employees must apply in HR Direct

Contact Center Specialist I

  • Job ID: 933750297
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: Monday to Friday 8:00 a.m. to 5:00 p.m.
  • Shift: Day Job
  • Facility: Pinnacle Health Medical Services - Admin
  • Department: Centralized Contact Ctr
  • Location: 3 Walnut Street, Lemoyne PA 17043
  • Union Position: No
  • Salary Range: $14.46 to $23.38 / hour

Description

Our team is growing and we have a variety of opportunities available for Contact Center Specialist I. If you’re passionate about patient care and looking for a career that offers great benefits and plenty of room for growth, we invite you to explore this opportunity today! 

Responsibilities:
  • 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.
  • Complete follow-up on unpaid account balances. Contact guarantors, third party payors, and/or other outside agencies for payment of balances due.
  • 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.
  • 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.
  • 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, review, and research credit balance accounts, potential refunds, adjustments, payment transfers, etc., to bring the account balance to zero.
  • 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.
  • Research, resolve and respond to email, web and telephone billing inquiries from patients and insurance carriers in accordance with departmental protocols.
  • 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.
  • 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.

Qualifications

  • High school graduate or equivalent. 
  • Two years of 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:
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

    Total Rewards

    More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

    Our Values

    At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

       Current UPMC employees must apply in HR Direct

    Talent Network