[Hiring] Research and Institutional Billing Lead @UPMC

Role Description

UPMC is looking to hire a full-time Research and Institutional Billing Lead. This position would work Monday through Friday during daylight hours and is eligible to work remotely, with occasional on-site work at the Quantum One Building as needed.

This position functions as a Lead to facilitate the appropriate billing and prompt/correct reimbursement for all monies owed by third parties. Responsibilities include:

• Monitoring the auditing of research requisitions to ensure proper billing of research-related services.
• Coordinating the billing process within the Health Services Division.
• Identifying inefficiencies.
• Monitoring institutional accounts for appropriate registration and reimbursement validation.
• Monitoring high dollar/aged accounts receivable to ensure collectability.

If you have research and institutional experience and are ready to grow your career, apply today!

Qualifications

• High School or equivalent and 4 years of healthcare billing experience including 2 years previous institutional billing experience or 6 years of research-related operations experience required.
• Bachelor's degree preferred.
• 2-4 years data entry experience.
• Keyboard dexterity and accuracy.
• Knowledge of medical terminology, ICD-9 and CPT coding preferred.
• Detail-oriented individual with excellent organizational, interpersonal, and communication skills.
• Knowledge of MS Office products.
• Ability to maintain designated quality and production standards.
• Proficiency in MS Office/PC skills preferred.

Requirements

• Refrain from disclosing or revealing confidential information to any person and do not access patient or coworker records (either electronic or files) except as specifically necessary to perform job duties.
• Document appropriate account activity and comment codes in respective billing system.
• Collate monthly invoice statements, retrieve and file folders as well as submission of monthly statements via e-mail or US mail for reimbursement.
• Obtain research requisitions and document accordingly.
• Monitor accounts receivable to facilitate the prompt resolution of accounts or issues with involved parties including the Revenue Cycle, Hospital Departments, and outside entities.
• Follow up status calls to institutional contact for payment.
• Assist in establishing goals to reduce the AR, improve cash collections and accounts receivable aging.
• Perform account analysis on problematic/aged accounts.
• Provide recommendations to develop process improvements relative to research and institutional billing/collections.
• Function as a liaison between research coordinators, research principal investigators, Compliance, and the Revenue Cycle.
• Responsible for Bad Debt process/Agency placements.
• Ensure compliant billing guidelines for Medicare Qualifying Trial and Investigational Device Clinical Trials.
• Register Institutional/Research professional and facility accounts in the Billing System.
• Review monthly institutional statements for accuracy, and make any necessary charge transfers or adjustments as well as contact to distribute bulk payments on institutional accounts to the specific charge transactions.
• Prepare/process facility intercompany journal entries.
• Upon request, provide all applicable rates for clinical trials and other requests.
• Provide education and training to increase awareness of Research billing regulations focusing on Medicare/payer guidelines, also including the use of institutional accounts.
• Assist in the development of policies and procedures.
• Support Revenue Cycle areas to ensure compliance of all revenue cycle protocols.
• Responsible for monthly professional research Sox controls and Epic Custom Menu maintenance.
• Perform all duties and responsibilities according to the philosophy and standards of UPMC, embracing the system-wide core competencies.
• Adhere to the UPMC and Revenue Cycle Standards of Conduct.
• Review corporate Fiscal Review form to confirm accuracy.
• Support and contribute to UPMC core values and guiding principles and abide by all UPMC departmental policies, procedures, and goals in the process of performing job responsibilities.
• Incorporates acts of dignity and respect in daily interactions.

Licensure, Certifications, and Clearances

• Act 34

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.