Payment Specialist II

UPMC•Pittsburgh, PA

1d•Hybrid

About The Position

UPMC Revenue Cycle is hiring a Payment Specialist II to join our team. The Payment Specialist II will work Monday through Friday during business hours from the US Steel Tower in Pittsburgh, PA. After training, a hybrid work schedule of working from home four days a week will be possible. In this role, you will analyze, post, balance, and report payments and denials for designated entities and payers to the appropriate billing system(s). As the Payment Specialist II you will manage electronic remittance file retrieval and posting as well as other various control processes (imaging, spreadsheet updating, account monitoring, etc). Apply today!

Requirements

High school diploma required.
Four years of experience in an accounts receivable environment, preferably in the health care or insurance field.
Knowledge of payment application, billing, and reconciliation.
Rapid typing/data entry skill and familiarity with personal computer software, such as but not limited to Excel.
Analytic mind that likes to resolve out-of-balance situations and math challenges.
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Nice To Haves

Associate or B.A. degree in accounting or business preferred.

Responsibilities

Analyze, post, balance, and report payments and denials for designated entities and payers to the appropriate billing system(s).
Manage electronic remittance file retrieval and posting.
Perform various control processes including imaging, spreadsheet updating, and account monitoring.
Expand knowledge of PLB processes by payer, recognizing when a PLB should be posted to a patient's account and verifying with the billing department.
Review EOB correspondence batches in the banking system, identify issues, and present them to management.
Interpret and key RAC Audit correspondence into the Audit+ system.
Understand payment posting and the relationship between co-pays, deductibles, co-insurance, allowances, and payments to ensure accurate account balances.
Navigate various payer websites or call payers directly when needed.
Key payment data from lockbox work, capturing all relevant data, including payer remark codes that would assist the Billing Department in determining how to follow up on a denial.
Verify that funds are in the bank prior to posting.
Import and post files, and reconcile funds in the bank to payments posted.
Print posted reports and manually post to the patient billing system any rejected payments and close the receivable to the next responsible payer as warranted.
Post and reconcile non-sufficient funds, credit files, stop payments, and any/all miscellaneous bank account debit adjustments and chargebacks.
Verify, import, and post electronic remittance/denial files for assigned payers, ensuring that funds are in the bank prior to posting.
Identify and communicate to management any unusual delays, balancing issues, new codes, or adjustments.
Manually resolve any rejected payments (post, refund, or transfer) for electronic remittance files.
Print summary reports.
Generate and distribute payer-specific electronic posting summary and exception reports to the department designee immediately upon completion of the payer file run.
Thoroughly research questionable/unidentified payments in order to post properly.
Contact insurance carriers, complete documentation forms, and follow up on any amounts posted to suspense, UTL, or clearing accounts.
Resolve items posted to suspense, UTL, or clearing accounts within 7 days, or provide notice to the supervisor of the reason for the extended delay.
Recognize bad debt transactions and supply proper documentation to ensure bad debt payment is posted accurately into any and all patient billing systems or legacy master spreadsheets.
Post and/or code non-cash data accurately by selecting the standard code to designate the reason (payment denial, admission approval, refund request, etc).
Post memo or contractual adjustment if warranted, and close the receivable to the next payer if warranted.
Prepare documentation for payments that must be transferred to another UPMC entity or refunded to the payer.
Ensure accurate posting of payments that belong to another UPMC entity or prepare appropriate documentation so that funds can be transferred or refunded.
Consistently meet departmental productivity standards as set by management.
Apply undistributed payments on any and all patient billing following established guidelines.
Serve as a resource to other employees, as requested by management.
Perform HB, PB & SBO payment postings.