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Job Summary:

Provide for the timely control, submission, collection, and analysis of all third party payor accounts. Provide for the on-going analysis of insurance verification, billing and collection efforts to insure a timely resolution of accounts. Make sound financial decisions to facilitate the resolution of third party accounts based on the information gathered from such sources at third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Billing/Collections Specialist.

Responsibilities:

+ Adhere to Fair Debt Collection Practices Act guidelines.

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

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

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

+ Deposits payments at bank in a secure and timely manner as needed.

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

+ Communicate pertinent reimbursement issues in a timely manner to Supervisor.

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

+ Assist in the development and maintenance of positive working relationships between the receivable team.

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

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

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

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

+ High school diploma or equivalent required.

+ Prefer Associates Degree in Business/Healthcare or 2 years experience as a secretary.

+ 3-5 years experience in accounts receivable environment OR equivalent combination of education and experience.

+ KNOWLEDGE, SKILLS & ABILITIES & INTERPERSONAL/LANGUAGE SKILLS Strong interpersonal, communication and collection skills required.

+ Knowledge of all third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial, etc.), the applicable reimbursement practices and familiar with automated patient billing systems.

+ History of successful third-party collection skills and decision-making capabilities

+ Ability to communicate with patients, payors, government offices, etc. through face to face, telephone and written correspondence.

+ Ability to act independently in a decisive and timely manner

+ Knowledge of ICD-9 and CPT Coding preferred.

+ Knowledge of medical terminology preferred.

+ Must possess good working knowledge of grammar and general office procedures.

+ Must possess a good working knowledge of word processing and spreadsheet software including Word and Excel.

+ The ability to use office machines (fax, copier, mail, etc.) preferred.

+ Must complete CRS Orientation, Facility-specific Orientation, and Department Specific Orientation(s) where appropriate.

+ Must possess the ability to provide customer services of the quality expected of CRS employees.

+ Must complete all mandatory competencies for system, CRS business unit and/or facility.

+ Must be organized and possess good time management skills and able to prioritize heavy workload.

+ Must possess effective written and verbal communication skills.

+ Must have strong interpersonal skills including the ability to interact with all personalitiesLicensure, Certifications, and Clearances:

+ Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran