Description

• Maintain a timely schedule of account resolution, reviewing all patient and insurance balances monthly.
• Follow policy and procedures developed for the handling of all client mail, insurance denials, and reimbursement irregularities.
• Utilize all tools available to ensure reimbursement, including but not limited to, sending of appeals, redeterminations and claim investigations.
• Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
• Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.
• Pursue information in an aggressive, yet highly professional manner.
• Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, and patients and/or their representatives.
• Communicate pertinent reimbursement issues in a timely manner to Supervisor
• Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.
• Maintain both yourself and your work in a manner consistent with a professional environment.
• Provide assistance to other department personnel as required through the direction of your supervisor.
• Adhere to Fair Debt Collection Practices Act guidelines.
• Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.

Qualifications

• High school diploma or equivalent. 
• Two years of experience in a billing or follow-up role of a healthcare or health insurance organization. 
• Familiarity and competence on one or multiple billing and patient accounting systems. 
• A team performance orientation with regard to department, payer and the ambulatory surgery centers. 
• An understanding and ability to communicate with third-party reimbursement and regulatory requirements. 
• Prior use of Microsoft Office applications recommended especially the use of Excel, Word and Access. 
• Understanding of CPT codes and familiarity with revenue codes. 
• Continued education and training to improve the understanding of payer communications, billing systems and analytical software tools.
  
• Additional knowledge relating to hospital registration systems and processes.
  

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.