Account Representative Sr

Responsibilities

• Perform duties and job responsibilities in alignment with UPMC Health System’s service management philosophy, demonstrating The Basics of Service Excellence towards patients, visitors, staff, peers, physicians, and other departments.
• Verify the accuracy of payment posting and reimbursement.
• Work with appropriate payers and/or department to resolve any payment discrepancies.
• Identify root cause issues and recommend corrective action steps to eliminate future occurrences of denials.
• Aid in the claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
• Manage assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments, and adjustments of accounts based on 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.
• Meet quality assurance benchmark standards and maintain productivity levels as defined by management.

Qualifications

• 1 year of claims/billing/collections experience; OR 4 years in a business office setting; OR a Bachelors Degree; OR an equivalent combination of education and experience.
• Excellent interpersonal, organizational, communication, and effective problem-solving skills are necessary.
• Must have prior working experience on personal computers, electronic calculators, and office equipment.
• 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.
• 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.