Billing/Collections Specialist - CCP Hybrid

UPMC•Wexford, PA

5d•Hybrid

About The Position

Are you passionate about helping kids be their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Billings/Collections Specialist to support the office in a hybrid role. EPIC experience preferred. Purpose: Provide for the timely control, submission, collection, and analysis of all third-party payor accounts. Provide for the on-going analysis of insurance verification, billing and collection efforts to insure a timely resolution of accounts. 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

Bachelor's degree in a relevant field, or
3-5 years of experience in a medical billing department and/or accounts receivable environment.
Knowledge of third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial) and reimbursement practices
Experience with automated patient billing systems
Successful third-party collections and decision-making in primary care or inpatient billing
Strong communication skills for interacting with patients, payors, and government offices
Ability to act independently and make timely decisions
Act 34

Nice To Haves

EPIC experience preferred.

Responsibilities

Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.
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.
Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate.
Observe UPMC HS policies and procedures.
Maintain both yourself and your work in a manner consistent with a professional environment.
Provide assistance to other department personnel as required through the direction of your supervisor.
Pursue information in an aggressive, yet highly professional manner.
Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.
Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.
Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.
Pursue the collection of accounts from the point of adjudication to the final resolution of the account.
Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers and patients and/or their representatives.
Interact with office personnel to ensure the cooperative flow of insurance and financial information on patients.
Adhere to Fair Debt Collection Practices Act guidelines.
Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
Assist in the development and maintenance of positive working relationships between the receivable team and clinical office personnel.