Contact Center Specialist- Wexford

UPMC•Wexford, PA

7d•Onsite

About The Position

UPMC Community Medicine Incorporated is hiring a full-time Contact Center Specialist for the Tri Rivers Musculoskeletal Center Call Center in Wexford, Pennsylvania. This is a Monday–Friday daylight position, with no nights, weekends, or holidays. The specialist supports Contact Center activities as the first point of contact for patients, providing guidance and education related to scheduling, registration, billing, claim status, and other patient inquiries. The role is responsible for resolving verbal and written inquiries efficiently and courteously, supporting patient satisfaction, and meeting call-service and quality standards. The position typically functions under the direction of a supervisor or manager. The specialist handles appointment scheduling, patient registration and record updates, appointment documentation, billing inquiries, account follow-up and payment arrangements, and patient access questions involving MyUPMC and telemedicine. The role also coordinates post-discharge appointments, documents account activity, researches billing and payment records, and addresses account balances in accordance with departmental protocols and applicable regulations.

Requirements

High school diploma or equivalent.
One year of general customer service experience.
Act 34 clearance.

Responsibilities

Answer calls on a multi-line telephone system, schedule appointments according to department protocols, and aim for patient satisfaction and first-call resolution.
Redirect calls or take messages as appropriate, coordinating with staff and leadership in other departments when needed.
Review, verify, enter, and update patient demographic, financial, and insurance information; verify and revise information for patients not interviewed within the past 30 days.
Complete, upload, scan, or fax forms and documents required for appointments, and follow up on incomplete or inaccessible information.
Obtain, verify, and correct registration information for new and existing patients; mail new-patient packets and handle medication refill requests.
Provide patients with guidance and education about scheduling, registration, appointment directions and parking, appointment preparation, billing, claims, and other patient inquiries.
Identify and address patient concerns, deciding whether to handle a call or refer it to clinical staff or a physician’s office.
Research, resolve, and respond to billing inquiries received by email, web, or telephone from patients and insurance carriers.
Follow up on unpaid account balances; contact guarantors, third-party payors, and other agencies regarding payment; establish payment plans, record arrangements, and monitor payments.
Counsel patients about local, state, and federal agencies that may offer assistance with health care funding.
Assist patients with MyUPMC access, telemedicine visits, and other online access concerns.
Contact patients about post-discharge appointment requirements and coordinate follow-up appointments.
Review accounts on aged trial balance reports or assigned work queues and take action according to specified dollar and age criteria; assign uncollectible accounts to external collection agencies monthly.
Document actions taken on patient accounts and review account histories and explanations of benefits to confirm payers have been billed and payments and adjustments are accurate.
Research credit balances, potential refunds, adjustments, and payment transfers to resolve account balances.
Follow Fair Debt Collection Practices Guidelines and applicable laws and regulations.
Perform in accordance with system-wide competencies and behaviors, and perform other duties as assigned.