Billing Collections Specialist

UPMC•Pittsburgh, PA

22h•Hybrid

About The Position

The Billing Collections Specialist provides the timely control, submission, collection, and analysis of all third-party payor accounts. They provide the on-going analysis of insurance verification, billing and collection efforts to ensure a timely resolution of accounts. Additionally, they make sound financial decisions to facilitate the resolution of third-party accounts based on the information gathered from such sources at third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Billing/Collections Specialist.

Requirements

High school diploma or equivalent required.
3-5 years of experience in accounts receivable environment OR equivalent combination of education and experience.
Strong interpersonal, communication and collection skills required.
Knowledge of all third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial, etc.), the applicable reimbursement practices and familiar with automated patient billing systems.
History of successful third-party collection skills and decision-making capabilities.
Ability to communicate with patients, payors, government offices, etc. through face to face, telephone and written correspondence.
Ability to act independently in a decisive and timely manner.
Knowledge of ICD-9 and CPT Coding preferred.
Knowledge of medical terminology preferred.
Must possess good working knowledge of grammar and general office procedures.
Must possess a good working knowledge of word processing and spreadsheet software including Word and Excel.
The ability to use office machines (fax, copier, mail, etc.) preferred.
Must complete CRS Orientation, Facility-specific Orientation, and Department Specific Orientation(s) where appropriate.
Must possess the ability to provide customer services of the quality expected of CRS employees.
Must complete all mandatory competencies for system, CRS business unit and/or facility.
Must be organized and possess good time management skills and able to prioritize heavy workload.
Must possess effective written and verbal communication skills.
Must have strong interpersonal skills including the ability to interact with all personalities
Act 34

Nice To Haves

Prefer Associates Degree in Business/Healthcare or 2 years of experience as a secretary.

Responsibilities

Adhere to Fair Debt Collection Practices Act guidelines.
Pursue information in an aggressive, yet highly professional manner.
Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, and patients and/or their representatives.
Deposit payments at bank in a secure and timely manner as needed.
Pursue the collection of accounts from the point of adjudication to the final resolution of the account.
Communicate pertinent reimbursement issues in a timely manner to Supervisor.
Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc.
Assist in the development and maintenance of positive working relationships between the receivable team.
Interact with personnel to ensure the cooperative flow of insurance and financial information on patients.
Provide assistance to other department personnel as required through the direction of your supervisor.
Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.
Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.