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Contact Center Specialist I

  • Job ID: 071124396
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Community Medicine Incorporated
  • Department: 55158 ZCMS1 PCP Monroeville
  • Location: 400 Oxford Dr, Monroeville PA 15146
  • Union Position: No
  • Salary Range: $14.79 to $22.56 / hour

Description

UPMC Community Medicine Incorporated is seeking a full-time Contact Center Specialist I to support UPMC Primary Care Partners – Monroeville!

The Contact Center Specialist will work daylight hours, 8 a.m. to 4:30 p.m. or 8:30 a.m. to 5:00 p.m., Monday through Friday. No evenings or weekends are required!

The Contact Center Specialist will provide support for the office by serving as the first line of contact for the patient. The Contact Center Specialist acts as an advocate for patients by providing guidance, interpretation, and education on scheduling, registration, billing, claim statuses, and various customer-related inquires.

Responsibilities include, but are not limited to, scheduling patient appointments (including providing directions, parking information, and required preparation), assisting the front desk staff, answering office phones, supporting check-in and check-out processes, scanning documents, and providing efficient and courteous resolutions to verbal and written inquiries to ensure customer satisfaction while maintaining call and quality standards. 

The ideal candidate for this position will have exceptional customer services skills, with a passion for communicating directly with patients and serving as a liaison between patients and providers. The Contact Center Specialist must be comfortable with primarily phone duties, but this role will be cross-trained in other areas to support the office. Medical terminology and/or health insurance knowledge is a plus!

*Free Parking*


Responsibilities:

  • Review, verify, and enter patient demographic and insurance information to ensure data integrity.
  • Answer multi-line telephone system and schedule appointments, contacting or paging physicians according to department questionnaires, protocols, and templates.
  • Understand UPMC's 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.
  • 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 understand the laws and regulations applicable to job functions.
  • Contact patients to discuss their post-discharge appointment requirements, following up and coordinating 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, setting up payment arrangements in the system and monitoring 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 online account history and EOBs 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/need for the patient's or clinician's 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 of 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:

  • Act 34

 

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   Current UPMC employees must apply in HR Direct