UPMC · 17 hours ago
Account Representative Sr
Pittsburgh, PA
Full-time
Onsite
Mid, Senior Level
1+ years expUPMC is a healthcare provider, and they are seeking a Senior Account Representative to manage fiscal functions related to patient and insurer payments. The role involves ensuring accurate claims submission, communicating payment issues, and mentoring staff in procedural direction.
BiotechnologyHealth CareHospitalMedical
Responsibilities
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
Ability to work multiple payers
Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies
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
Managed 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
Evaluate and recommend referrals to agency, law firm, Financial Assistance and Bad Debt
Understand third party billing and collection guidelines
Demonstrate knowledge of the current functionality of the patient accounting systems
Identify issues and submit corrective action recommendations
Ability to work independently with minimal supervision
Meet quality assurance benchmark standards and maintain productivity levels as defined by management
Must have 1 year of claims/billing/collections experience
OR 4 years in a business office setting
OR a Bachelors Degree
OR an equivalent combination of education and experience
Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary
Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence
Prior working experience on personal computers, electronic calculators and office equipment is needed
Must be multi-disciplined in billing, collections, denials, credit balances and/or the various payers
Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred
Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial
This position requires organization and time management skills
The incumbent must develop and manage relationships with colleagues in a professional, independent manner
The position requires the ability to maintain confidentiality with regard to all assignments
Qualification
Required
Must have 1 year of claims/billing/collections experience
OR 4 years in a business office setting
OR a Bachelors Degree
OR an equivalent combination of education and experience
Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary
Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence
Prior working experience on personal computers, electronic calculators and office equipment is needed
Must be multi-disciplined in billing, collections, denials, credit balances and/or the various payers
This position requires organization and time management skills
The incumbent must develop and manage relationships with colleagues in a professional, independent manner
The position requires the ability to maintain confidentiality with regard to all assignments
Act 34
Preferred
Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred
Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial
Company
UPMC
UPMC is one of the leading nonprofit health systems in the United States. A $10 billion integrated global health enterprise headquartered
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$0.46MKey Investors
Appalachian Regional Commission
2024-09-18Grant· $0.46M
Leadership Team
Leslie Davis
President and CEO
Frederick M. Hargett
Chief Financial Officer
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