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   Current UPMC employees must apply in HR Direct

Contact Center Specialist I

  • Job ID: 197520946
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: see description for hours
  • Shift: Day Job
  • Facility: Pinnacle Health Support Services
  • Department: Patient FinancialSupport
  • Location: 1200 Camp Hill Bypass, Camp Hill PA 17011
  • 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 customer service, are comfortable working in a call center, 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 will work the following shifts: Monday, Wednesday, Friday from 8:00 a.m. to 4:30 p.m. and Tuesday and Thursday from 9:45 a.m. to 6:15 p.m.

Location of this position is at the Single Billing Office, 1200 Camp Hill Bypass, Camp Hill, PA 17011.

Responsibilities:
  • Resolves patient complaints and answers patient inquiries using knowledge of billing regulations for third party payers explaining why or how the insurances deny or pay certain charges. Often explaining to the how or why their high dollar deductible plan does or doesn’t cover certain charges. 
  • Resolves billing issues within the Epic system.
    Researches and communicates with the departments throughout UPMC to resolve patient concerns regarding billing issues. 
  • The ability to understand and explain the differences in an inpatient stay versus an observation stay versus outpatient billing. 
  • Provides customer service for patients or their representatives, which can include why there were changes to their outstanding balances. 
  • Determine appropriate need for account adjustments to be performed in accordance with department policy.
    Provides customer service including but not limited to physician offices, the emergency room and/or secondary billing companies. 
  • Process patient payments. 
  • Setting up payment arrangements with third party vendor including the review of balances, explaining payment programs, determining payment amounts and terms utilizing a monthly payment calculator, documenting and adjusting accounts as needed. 
  • Ability to understand bad debt accounts.
    Ability to understand financial aid assistance. Answer questions on Financial Aid applications. 
  • Ability to understand estimates to clearly explain the reason why a bill is received when a payment was taken previous to the service. 
  •  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. 
  • Research, resolve and respond to email, web and telephone billing inquiries from patients in accordance with departmental protocols. 
  • Demands and mails copies of patient bills upon request. 
  • Process miscellaneous correspondence – update accounts with new or corrected billing information for claim submission. 
  • Performs other duties as assigned within the department by management.
    Refers patients to a patient representative/advocate when related to a care issue. 
  • Utilizes multiple systems to conduct appropriate research concerning the patient issue. 
  • Works with billing department for all billing related inquiries. 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 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

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       Current UPMC employees must apply in HR Direct

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