Pennsylvania Staffing
Account Representative Sr
Pennsylvania Staffing, Pittsburgh, Pennsylvania, United States, 15201
Account Representative, Senior
The Account Representative, Senior is responsible for all fiscal functions necessary to ensure the prompt and correct payment to the hospital of all monies owed by both insurers and patients. Account Representatives, Senior are responsible to: ensure claims are submitted accurately and timely; communicate with insurance companies, patients and physicians regarding payment issues; establish reasonable payment arrangements; recommend adjustments according to UPMC policies; review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts; identify and assign appropriate status codes; and review high dollar accounts on a regular basis. The Account Representative, Senior is expected to identify recurring problems and procedural deficiencies that need to be reported to management and to serve as a key mentor to staff for training and procedural direction. Responsibilities include: performing duties in a fashion which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians and other departments within the organization; ability to work multiple payers; verifying accuracy of payment posting and reimbursement; working with appropriate payer and/or department to resolve any payment discrepancies; identifying root cause issues and demonstrating the ability to recommend corrective action steps to eliminate future occurrences of denials; assisting in claim appeal process and/or performing follow-up in accordance with Revenue Cycle policies and procedures; managing assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards; evaluating and recommending referrals to agency, law firm, Financial Assistance and Bad Debt; understanding third party billing and collection guidelines; demonstrating knowledge of the current functionality of the patient accounting systems; identifying issues and submitting corrective action recommendations; ability to work independently with minimal supervision; meeting quality assurance benchmark standards and maintaining productivity levels as defined by management. Must have 1 year of claims/billing/collections experience; OR 4 years in a business office setting; OR a Bachelor's Degree; OR an equivalent combination of education and experience. Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary. Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence. Prior working experience on personal computers, electronic calculators and office equipment is needed. Must be multi-disciplined in billing, collections, denials, credit balances and/or the various payers. Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred. Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial. This position requires organization and time management skills. The incumbent must develop and manage relationships with colleagues in a professional, independent manner. The position requires the ability to maintain confidentiality with regard to all assignments. Licensure, Certifications, and Clearances: Act 34. UPMC is an Equal Opportunity Employer/Disability/Veteran.
The Account Representative, Senior is responsible for all fiscal functions necessary to ensure the prompt and correct payment to the hospital of all monies owed by both insurers and patients. Account Representatives, Senior are responsible to: ensure claims are submitted accurately and timely; communicate with insurance companies, patients and physicians regarding payment issues; establish reasonable payment arrangements; recommend adjustments according to UPMC policies; review the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts; identify and assign appropriate status codes; and review high dollar accounts on a regular basis. The Account Representative, Senior is expected to identify recurring problems and procedural deficiencies that need to be reported to management and to serve as a key mentor to staff for training and procedural direction. Responsibilities include: performing duties in a fashion which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians and other departments within the organization; ability to work multiple payers; verifying accuracy of payment posting and reimbursement; working with appropriate payer and/or department to resolve any payment discrepancies; identifying root cause issues and demonstrating the ability to recommend corrective action steps to eliminate future occurrences of denials; assisting in claim appeal process and/or performing follow-up in accordance with Revenue Cycle policies and procedures; managing assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards; evaluating and recommending referrals to agency, law firm, Financial Assistance and Bad Debt; understanding third party billing and collection guidelines; demonstrating knowledge of the current functionality of the patient accounting systems; identifying issues and submitting corrective action recommendations; ability to work independently with minimal supervision; meeting quality assurance benchmark standards and maintaining productivity levels as defined by management. Must have 1 year of claims/billing/collections experience; OR 4 years in a business office setting; OR a Bachelor's Degree; OR an equivalent combination of education and experience. Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary. Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence. Prior working experience on personal computers, electronic calculators and office equipment is needed. Must be multi-disciplined in billing, collections, denials, credit balances and/or the various payers. Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred. Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial. This position requires organization and time management skills. The incumbent must develop and manage relationships with colleagues in a professional, independent manner. The position requires the ability to maintain confidentiality with regard to all assignments. Licensure, Certifications, and Clearances: Act 34. UPMC is an Equal Opportunity Employer/Disability/Veteran.