Account Representative Sr

UPMC • Pittsburgh, PA • 2h ago

Purpose:

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. Account Representatives, Senior are responsible to: ensure claims are submitted accurately and timely; communicate with insurance companies, patients and physicians regarding payment issues; establish reasonable payment arrangements; recommend adjustments according to UPMC policies; review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts; identify and assign appropriate status codes; and review high dollar accounts on a regular basis. The Account Representative, Senior is expected to identify recurring problems and procedural deficiencies that need to be reported to management and to serve as a key mentor to staff for training and procedural direction.

Responsibilities:

Perform duties and job responsibilities in a fashion which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians and other departments within the organization.

Ability to work multiple payers

Verify accuracy of payment posting and reimbursement.

Work with appropriate payer and/or department to resolve any payment discrepancies.

Identify root cause issues and demonstrate the ability to 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.

Managed assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards.

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 the 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.

Must have 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 are necessary.

Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence.

Prior working experience on personal computers, electronic calculators and office equipment is needed.

Must be multi-disciplined in billing, collections, denials, credit balances and/or the various payers.

Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred.

Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial.

This position requires organization and time management skills.

The incumbent must develop and manage relationships with colleagues in a professional, independent manner.

The position requires the ability to maintain confidentiality with regard to all assignments.Licensure, Certifications, and Clearances:

Act 34UPMC is an Equal Opportunity Employer/Disability/Veteran

UPMC

Go to Apply

Share this job

Similar Jobs

Account Representative Sr

UPMC • Pittsburgh, PA • 2h ago

Sales & Marketing

Job Summary: 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. Account Represe...

2h ago

Go to Apply

Special Event Coordinator - 26003235

University of Pittsburgh • Pittsburgh, PA • 15h ago

Sales & Marketing

Special Event Coordinator Office of the SVC and Provost - Pennsylvania-Pittsburgh - (26003235) The Office of the Provost Business Team is looking for a Special Event Coordinator to support the planning and execution of O...

15h ago

Go to Apply

Marketing Specialist Sr

PNC • Pittsburgh, PA • 19h ago

Sales & Marketing

Position Overview At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together each day to...

19h ago

Go to Apply

Marketing Specialist

PNC • Pittsburgh, PA • 19h ago

Sales & Marketing

19h ago

Go to Apply

Account Executive II

WM • Pittsburgh, PA • 1d ago

Sales & Marketing

I. Job Summary Remote position but candidates must be located within the Capitol Market Area, hours are 7:30-4:00. The Account Executive II (AE) generates shareholder value by using a consultative retention approach for...

1d ago

Go to Apply

Alliance Marketing Director- SAP

PwC • Pittsburgh, PA • 1d ago

Sales & Marketing

Specialty/Competency: IFS - Clients & Markets Industry/Sector: Not Applicable Time Type: Full time Travel Requirements: Up to 20% At PwC, our people in brand management, marketing and sales focus on collaboration to...

1d ago

Go to Apply

Sales Associate

Aaron's Inc • Pittsburgh, PA • 2d ago

Sales & Marketing

Sales Associate The salary range for this role is $14.00 to $14.00 per hour/annually.* This position is also eligible for incentive pay based on performance. Sales Associates keep people smiling at Aaron's . On our team,...

2d ago

Go to Apply

Medicare Sales Support Representative- Remote

UPMC • Pittsburgh, PA • 2d ago

Sales & Marketing

The Medicare Sales Support Representative provides administrative, operational, and customer support for the Medicare Sales team at UPMC Health Plan. This remote position is responsible for assisting sales representative...

2d ago

Go to Apply

Associate Marketing Lead - XSell Digital Marketing

PNC • Pittsburgh, PA • 2d ago

Sales & Marketing

2d ago

Go to Apply

Sales Engineer

Mitsubishi Electric Power Products, Inc. • Warrendale, PA • 3d ago

Sales & Marketing

Location: Warrendale, PA Job ID: 3575 Position @type Hybrid Telework Powering Customer Partnerships Through Technical & Commercial Excellence! MEPPI's High Voltage Switchgear Division (HVSD) is seeking an experienced...

3d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)