Account Representative

Manage all fiscal functions necessary to ensure prompt and correct payment to the hospital of all monies owed to the provider by insurers and patients. Ensure claims are submitted accurately and timely, communicate with insurance companies, patients, and physicians regarding payment issues, establish reasonable payment arrangements, and 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.

The work hours are Monday through Friday from 7:30 AM-4:00 PM. The position can become fully remote after the successful completion of in-person training period.

Responsibilities:

Understand Third Party Billing and Collection Guidelines.

Work with the appropriate payer and/or department to resolve any payment discrepancies.

Verify the accuracy of payment posting and reimbursement.

Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials.

Assist in the claim appeal process and/or perform follow-up per Revenue Cycle policies and procedures.

High school graduate or equivalent.

Ability to communicate with patients, payors, outside agencies, and the general public through telephone, electronic, and written correspondence.

Working experience with personal computers, electronic calculators, and various office equipment is needed.

Collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred.

Familiarity with third-party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial. Licensure, Certifications, and Clearances:

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UPMC is an Equal Opportunity Employer/Disability/Veteran