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Charge Processing Specialist II

  • Job ID: 033375627
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Community Medicine Incorporated
  • Department: 55540 ZCMS1 LPA South Side
  • Location: 2310 Jane Street, Pittsburgh PA 15203
  • Union Position: No
  • Salary Range: $14.79 to $22.56 / hour

Description

UPMC Community Medicine Incorporated is seeking a full-time Charge Processing Specialist II to support Lindenbaum, Perryman, & Associates at the UPMC Outpatient Center in the South Side!

The Charge Processing Specialist II ensures that Managed Care requirements are met by accessing the referral system and attaching the pre-loaded authorization to the charge being processed. Additional responsibilities include, but are not limited to, working through charge review claims, claim edits and denials, billing duties, handling insurance company and patient calls, gathering insurance information, and additional authorization submittal support tasks. 

The ideal candidate for this position will have previous physician office experience, with a working knowledge of registration, insurance verification, and/or charge and payment posting. Medical terminology knowledge is preferred, while previous authorization experience is a plus!

*Free Parking*


Responsibilities:

  • Verify that the appropriate Place of Service (POS) code is submitted in relation to the rendered procedure Type of Service (TOS) at the charge entry level based on the payer-specific requirements.
  • Coordinate the exchange of information/documentation with other practice plans or ancillary departments.
  • Document and resolve all problem charge vouchers on a daily basis.
  • Assist in the processing of charges, which includes institutional accounts, charge override services, and payment transfers for cosmetic services.
  • Process charge documents into the Epic system and maintain minimum productivity levels.
  • Perform limited ICD-9 and CPT-4 coding from charge slips, encounter forms, or source documentation.
  • Ensure the charges for bilateral services are processed in accordance with payer-specific guidelines.
  • Review coding and charges for accuracy and completeness.
  • Ensure physician charges are applied to the correct account by verifying information indicated on the charge document against the system information.
  • Ensure the appropriate modifier is attached at the charge entry level for Medicare non-covered and limited coverage service and for resident participation.
  • Assist in the processing of charge correction requests, documenting types of corrections performed in addition to verifying the validity of the requests received.
  • Verify that all charge batches entered are processed with the correct revenue location.
  • Balance charges entered at the end of the day, each day.

 

Qualifications

  • High School diploma or equivalent required.
  • Three years of experience in registration, scheduling, insurance verification, and charge and payment posting processes within a physician office practice preferred.
  • Strong verbal, telephone, and written correspondence skills.
  • Knowledgeable of medical terminology, cash collection and application, ICD-9/CPT-4 coding, and third-party payer billing and reimbursement practices.
  • Ability to effectively problem-solve.
  • Prior working experience on personal computers and various office equipment.


Licensure, Certifications, and Clearances:

  • Act 34

 

UPMC has a Center for Engagement and Inclusion that is charged with executing leading-edge and next-generation diversity strategies to advance the organization’s diversity management capability and its national presence as a diversity leader. This includes having Employee Resource Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Differences) Network, which support the implementation of our diversity strategy. 

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct