UPMC Corporate Services is hiring a full-time Account Representative to help support the Patient Business Services Department for its South Side location. The Account Representative will manage all fiscal functions necessary to ensure the prompt and correct payment to the hospital of all monies owed by both insurers and patients. The incumbent will 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. The Account Representative will review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts. The incumbent will identify and assign appropriate status codes. The hours for this position are Monday through Friday.
- Attend compliance training as defined in the compliance training policy.
- Refrain from disclosing or revealing confidential information to any person, except as specifically necessary for the staff member to perform his or her job duties. Shall not access patient or coworker records (either electronic or files) except as specifically necessary for the staff member to perform his or her job duties.
- Document appropriate account activity in system(s).
- Monitor report activities as defined in policies and procedures as related to your area of responsibility.
- Understand Third Party billing regulations and submit bills, re-bills and/or reprints in accordance with payer guidelines. Maintain department productivity levels.
- Understand the Billing/Collection regulations relative to Medicare, Medical Assistance, Managed Care Contracts, Blue Cross, Act 6, and Act 44 as applicable.
- Monitor outstanding accounts receivable balances, insuring timely resolution/payment of accounts.
- Maintain department productivity levels and compliance with quality standards.
- High school diploma 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 ICD9, 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.
UPMC is an equal opportunity employer.
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