Posted on: November 24, 2022
Manage all fiscal functions necessary to ensure the prompt and
correct payment to the hospital of all monies owed to the provider
by insurers and patients. 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.
Review the posting and balancing of payment/denial and adjustment
transactions necessary for closing accounts. Identify and assign
appropriate status codes.
The work hours are from 7:00 a.m. to 3:30 p.m., 7:30 a.m. to 4:00
p.m. or 8:00 a.m. to 4:30 p.m. A schedule must be selected.
Remote / hybrid work is available after 6 months of successful
on-site training is completed. Must have high speed internet and
office set up.
+ Understand Third Party Billing and Collection Guidelines.
+ 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.
+ 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.
+ Evaluate and recommend referrals to agency, law firm, Financial
Assistance and Bad Debt.
+ Verify accuracy of payment posting and reimbursement. Work with
appropriate payer and/or department to resolve any payment
+ Demonstrate knowledge of the current functionality of the patient
+ Manage 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
+ Meet quality assurance, benchmark standards and maintain
productivity levels as defined by management.
+ Identify issues and submit corrective action recommendations.
+ High school graduate or equivalent. Excellent interpersonal,
organizational, communication and effective problem solving skills
+ 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
+ Familiarity with third party payor guidelines and reimbursement
practices and available financial resources for payment of balances
due is beneficial.
**Licensure, Certifications, and Clearances:**
+ Act 33 with renewal
+ Act 34 with renewal
+ Act 73 FBI Clearance with renewal
**UPMC is an Equal Opportunity Employer/Disability/Veteran**
**Individuals hired into this role must comply with UPMC's COVID-19
vaccination requirements upon beginning employment with UPMC. Refer
to the COVID-19 Vaccination Information section at the top of this
page to learn more.**
Keywords: UPMC, Ellicott City , Account Representative, Other , Hanover, Maryland
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