Account Representative Sr

About the role

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. Key responsibilities include verifying accuracy of payment posting and reimbursement, resolving payment discrepancies, identifying and recommending corrective actions, and managing assigned book of business.

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.
• Ability to work with multiple payers.
• Verify accuracy of payment posting and reimbursement, working with appropriate payer and/or department to resolve any payment discrepancies.
• Identify root cause issues and 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.
• Maintain quality assurance benchmark standards and 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 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.