[Hiring] Senior Account Representative @UPMC

Role Description

UPMC Corporate Revenue Cycle is hiring an Account Representative, Senior to join our Claims Department. This position will have the opportunity to work from home.

The Account Representative, Senior is responsible for all fiscal functions necessary to ensure the prompt and correct payment to the hospital of all monies owed by both insurers and patients. Responsibilities include:

• Ensuring claims are submitted accurately and timely.
• Communicating with insurance companies, patients, and physicians regarding payment issues.
• Establishing reasonable payment arrangements.
• Recommending adjustments according to UPMC policies.
• Reviewing the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts.
• Identifying and assigning appropriate status codes.
• Reviewing high-dollar accounts on a regular basis.
• Identifying recurring problems and procedural deficiencies to report to management.
• Serving as a key mentor to staff for training and procedural direction.

Qualifications

• 1 year of claims/billing/collections experience; OR 4 years in a business office setting; OR a Bachelor's Degree; OR an equivalent combination of education and experience.
• Excellent interpersonal, organizational, communication, and effective problem-solving skills.
• Ability to communicate with patients, payers, outside agencies, and the general public through telephone, electronic, and written correspondence.
• Prior working experience on personal computers, electronic calculators, and office equipment.
• Multi-disciplined in billing, collections, denials, credit balances, and/or various payers.
• Prior collections or medical billing experience with a basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred.
• Familiarity with third-party payer guidelines and reimbursement practices.
• Organization and time management skills.
• Ability to maintain confidentiality regarding all assignments.

Requirements

• Ability to work multiple payers.
• Verify accuracy of payment posting and reimbursement.
• Identify root cause issues and 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.
• Manage assigned book of business ensuring timeliness and accuracy of billing, collections, contractual postings, payments, and adjustments.
• 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 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.

Licensure, Certifications, and Clearances

• Act 34

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.