Billing/Collections Specialist - UPMC : Job Details

The ASC Managed Services department is looking for a new Billing/Collections Specialist to join their team. This position will oversee appeals and account receivable process.

Schedule: Monday - Friday from 8:00 a.m. - 4:30 p.m., schedule can be flexible. No weekends or holidays.

Work from home 4 days a week in the office 1 day a week. This position does require in person training at the start, timeline varies based off learning speed.

**Responsibilities:**

+ Assist in the development and maintenance of positive working relationships between the receivable team and surgery center facility personnel.

+ Interact with the surgery center personnel to ensure the cooperative flow of insurance and financial information on patients.

+ Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.

+ Communicate pertinent reimbursement issues in a timely manner to manager, director, and surgery center.

+ Adhere to the UPMC Health System Standards of Conduct.

+ Observe both UPMC HS and policies and procedures.

+ Maintain both yourself and your work in a manner consistent with a professional environment.

+ Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.

+ Provide assistance to other department personnel as required through the direction of your supervisor.

+ Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate.

+ Adhere to Fair Debt Collection Practices Act guidelines.

+ Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, surgery center facilities and patients and/or their representatives.

+ Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.

+ Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc.

+ Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.

+ Pursue information in an aggressive, yet highly professional manner.

+ Pursue the collection of surgical accounts from the point of adjudication to the final resolution of the account

+ Pursue information in an aggressive, yet highly professional manner.

+ Provide assistance to other department personnel as required through the direction of your supervisor

+ High school diploma or equivalent.

+ Two years of experience in a billing or follow-up role of a healthcare or health insurance organization.

+ Familiarity and competence on one or multiple billing and patient accounting systems.

+ A team performance orientation with regard to department, payer and the ambulatory surgery centers.

+ An understanding and ability to communicate with third-party reimbursement and regulatory requirements.

+ Prior use of Microsoft Office applications recommended especially the use of Excel, Word and Access.

+ Understanding of CPT codes and familiarity with revenue codes.

+ Continued education and training to improve the understanding of payer communications, billing systems and analytical software tools.

+ Additional knowledge relating to hospital registration systems and processes.

**Licensure, Certifications, and Clearances:**

+ Act 34

**UPMC is an Equal Opportunity Employer/Disability/Veteran**