COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Account Representative (Claim Integrity)

  • Job ID: 668601477
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Revenue Cycle
  • Department: Rev Cyc Claims
  • Location: 2 Hot Metal Street, Pittsburgh PA 15203
  • Union Position: No
  • Salary Range: $15.65 to $24.56 / hour

Description

At UPMC, we’re all here for the same reason — to make Life Changing Medicine happen. Join our team and you will play a unique and important role in our mission to change healthcare for the better

Why Join UPMC?

We don’t just take care of patients — we take care of our team, too. And we have the data to prove it. In addition to the benefits you’d expect from an industry leader you can expect:

  • AWARD-WINNING WORKPLACE: Ranked #1 for Best Places to Work for Women & Diverse Managers. And 2020 Corporate Equality Index.
  • A recent study showed that UPMC benefits are 20% higher in value than other healthcare providers in our market.
  • Tuition reimbursement
  • Competitive pay
  • Opportunities to grow in your career at UPMC
UPMC Corporate Revenue Cycle is hiring an Account Representative to join our Claim Integrity team!  This position will work Monday through Friday during daylight hours with a hybrid schedule, work from home and in-office at the Quantum One building.
 
The Account Representative will manage all fiscal functions necessary to ensure the prompt and correct payment to the hospital of all monies owed to the provider by insurers and patients.  As well as ensure claims are submitted accurately and timely, communicate with insurance companies, patients and physicians regarding payment issues, establish reasonable payment arrangements and recommend adjustments according to UPMC policies.  The role will review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts.  Plus identify and assign appropriate status codes.
 
Do you have prior experience with insurance registration?  If so, this could be the next step in your career.   Apply today!

Responsibilities:
  • Understand Third Party Billing and Collection Guidelines.
  • Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials. Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
  • Perform duties and job responsibilities in a fashion, which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians, and other departments within the organization.
  • Evaluate and recommend referrals to agency, law firm, Financial Assistance and Bad Debt.
  • Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies.
  • Demonstrate knowledge of the current functionality of the patient accounting systems.
  • Manage assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards.
  • Meet quality assurance, benchmark standards and maintain productivity levels as defined by management.
  • Identify issues and submit corrective action recommendations.
  • Locate all EOB requests, both electronic and manual, documenting the accounts when required, and returning them daily to the requestor. Any unfound backup or EOB batches that have not been scanned into EPIC need brought to management's attention.
  • Deliver daily to the requester all medical records pulled by the MR Team and document the patient account as required.
  • Fax any PWK Files as needed. Must be completed daily
  • Incoming mail is to be distributed daily. Outgoing mail is to be collected throughout the day, and taken to the designated delivery/pick up area daily between 2:30PM and 3:00PM.
  • Assist Billing with projects as requested.
  • Scan Exhaust Letters' as needed. Must be completed daily.
  • Sort and count paper claims received daily, distributing them daily to the assigned Billing Representative(s). Volumes to be recorded in the designated Shared Drive file.

 

Qualifications

  • High school graduate or equivalent.
  • Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary.
  • Ability to communicate with patients, payors, outside agencies, and the general public through telephone, electronic and written correspondence.
  • Working experience on personal computers, electronic calculators and various office equipment is needed.
  • Collections or medical billing experience with a basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred.
  • Familiarity with third-party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial.

Licensure, Certifications, and Clearances:
  • Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran

 

At UPMC, we strive to ensure that diversity, inclusion, dignity, respect, and cultural awareness is at the core of everything we do. By fostering an environment where every member of our team has a voice, regardless of race, ethnicity, gender identity, sexual orientation, faith, age, or culture, we aim to emphasize a simple point: who you are is important, and who you are has a place at UPMC.

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

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