Description

Purpose:
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. 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. Review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts. Identify and assign appropriate status codes.

Responsibilities:

• Responsible for welcoming patients upon arrival, assisting with check-in and answering phones, educating patients on their copayments and financial obligations, collecting payments when applicable, scheduling subsequent appointments within the continuum of care.
• Connecting patients to financial advocacy resources when appropriate, updating patient’s demographics and insurance coverage information, and promoting an overall culture of service excellence. 
• 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.
• Demonstrate knowledge of the current functionality of the patient accounting systems.
• Meet quality assurance, benchmark standards and maintain productivity levels as defined by management.
• Identify issues and submit corrective action recommendations.

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 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 basic understanding of ICD10, 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:
Clearances must be within 5 years of hire date

• Act 33 with renewal
• Act 34 with renewal
• Act 73 FBI Clearance with renewal


• UPMC is an Equal Opportunity Employer/Disability/Veteran

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