AR Account Specialist, Sr.

Responsibilities

• Communicates with patients and outside agencies regarding payment issues.
• Establishes reasonable payment arrangements, determines charity eligibility, and recommends write-offs according to UPMC Cancer Center policies.
• Verifies accuracy of payment posting and reimbursement.
• Works with appropriate payer and/or department to resolve any payment discrepancies.
• 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.
• Absorb and 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.
• Work with appropriate payer and/or department to resolve any payment discrepancies.
• Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
• Demonstrate knowledge of the current functionality of the patient accounting system.
• Identify issues and submit corrective action recommendations.
• Work independently with minimal supervision.
• Understand complex reimbursement issues.
• 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.
• Absorb and actively engage in process improvement for efficiency gains.
• Able to review complex issues, determine the root cause issue and present a solution that will result in a cost reduction the majority of the time.
• Meet quality assurance benchmark standards and maintain productivity levels as defined by management.
• Develop and manage relationships with colleagues in a professional, independent manner.
• The incumbent must maintain confidentiality with regard to all assignments.

Qualifications

• High school diploma or equivalent and 3 years of billing, registration or patient business services or equivalent combination of education and experience.
• Excellent interpersonal, organizational, communication and effective problem solving skills are necessary.
• This position requires organization and time management skills.
• Prior working experience in billing/collections, denials, credit balances and/or various payers.
• Licensure, Certifications, and Clearances: Act 34