Billing/Collections Specialist

The ASC Managed Services department is looking for a new Billing/Collections Specialist to join their team. This position will oversee appeals and account receivable process.Schedule: Monday – Friday from 8:00 a.m. – 4:30 p.m., schedule can be flexible. No weekends or holidays.Work from home 4 days a week in the office 1 day a week. This position does require in person training at the start, timeline varies based off learning speed.Responsibilities:

Assist in the development and maintenance of positive working relationships between the receivable team and surgery center facility personnel.

Interact with the surgery center personnel to ensure the cooperative flow of insurance and financial information on patients.

Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.

Communicate pertinent reimbursement issues in a timely manner to manager, director, and surgery center.

Adhere to the UPMC Health System Standards of Conduct.

Observe both UPMC HS and policies and procedures.

Maintain both yourself and your work in a manner consistent with a professional environment.

Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.

Provide assistance to other department personnel as required through the direction of your supervisor.

Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate.

Adhere to Fair Debt Collection Practices Act guidelines.

Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, surgery center facilities and patients and/or their representatives.

Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.

Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc.

Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.

Pursue information in an aggressive, yet highly professional manner.

Pursue the collection of surgical accounts from the point of adjudication to the final resolution of the account

Pursue information in an aggressive, yet highly professional manner.

Provide assistance to other department personnel as required through the direction of your supervisor

High school diploma or equivalent.

Two years of experience in a billing or follow-up role of a healthcare or health insurance organization.

Familiarity and competence on one or multiple billing and patient accounting systems.

A team performance orientation with regard to department, payer and the ambulatory surgery centers.

An understanding and ability to communicate with third-party reimbursement and regulatory requirements.

Prior use of Microsoft Office applications recommended especially the use of Excel, Word and Access.

Understanding of CPT codes and familiarity with revenue codes.

Continued education and training to improve the understanding of payer communications, billing systems and analytical software tools.

Additional knowledge relating to hospital registration systems and processes.

Licensure, Certifications, and Clearances:

Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran