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UPMC · 1 week ago

Account Representative- In Office

Pittsburgh, PA

Full-time

Onsite

New Grad, Entry Level

UPMC is a healthcare provider seeking an Account Representative to manage fiscal functions related to payment collection from insurers and patients. The role involves ensuring accurate claims submission, resolving payment discrepancies, and maintaining communication with various stakeholders regarding payment issues.

BiotechnologyHealth CareHospitalMedical

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

Qualification

Third Party BillingCollections ExperienceMedical BillingICD9 UnderstandingCPT4 UnderstandingHCPCS UnderstandingPatient Accounting SystemsOffice Equipment ProficiencyFinancial Assistance KnowledgeInterpersonal SkillsOrganizational SkillsCommunication SkillsProblem-Solving Skills

Required

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

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

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

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

Licensure, Certifications, and Clearances: Act 34