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   Current UPMC employees must apply in HR Direct

Payor Specialist--Harrisburg

  • Job ID: 624274537
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: see description for hours
  • Shift: Day Job
  • Facility: UPMC Pinnacle Hospitals
  • Department: Outcomes Management
  • Location: 111 South Front Street, Harrisburg PA 17105
  • Union Position: No
  • Salary Range: $15.19 to $22.65 / hour

Description

Purpose:
Performs a variety of clerical, secretarial and payor related functions.

Hours:

This position will work Monday to Friday, 8:30 a.m. to 5:00 p.m., and includes every 11th weekend (both Saturday and Sunday) from 8:00 a.m. to 4:30 p.m.


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 and documents interactions in Epic.
  • 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.
  • Enter and maintain authorization/certification information in Epic System as it is obtained.
  • 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 or equivalent and one year of claims, billing, or collections experience OR Four years in a business office setting or Bachelor's degree or equivalent combination of education and experience.
  • Excellent communication skills, both written and verbal.
  • Coordination and interpersonal skills along with the ability to exercise independent judgment.
  • Thorough knowledge of Microsoft Word, 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

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — 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