Location: Bridgeville,PA, USA
UPMC Rx Partners is looking for a full time Billings/Collections Specialist to join their dedicated team!
You will provide for the timely control, submission, collection, and analysis of all third party payor accounts. Provide for the on-going analysis of insurance verification, billing and collection efforts to insure a timely resolution of accounts. Make sound financial decisions to facilitate the resolution of third party accounts based on the information gathered from such sources at third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Billing/Collections Specialist.
This role will work 9 am to 5:30 pm, Monday through Friday, as well as one Saturday every five weeks.
UPMC offers a generous benefits package, an expansive total rewards package, opportunity to grow your career and much more. Apply today!
Responsibilities:
* Assist in the development and maintenance of positive working relationships between the receivable team and nursing home facility personnel.
* Interact with the Nursing Home 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 Supervisor, CEO and Nursing Home.
* Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.
* Observe both UPMC HS and Rx Partners-LTC 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, nursing home 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.
* Pursue the collection of pharmacy accounts from the point of adjudication to the final resolution of the account.
* Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
* Pursue information in an aggressive, yet highly professional manner.
Qualifications:
* A Bachelor's degree; or 3-5 years experience as a retail pharmacy technician or 3-5 years experience in pharmacy accounts receivable environment
* Strong interpersonal, communication and collection skills required
* Knowledge of all third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial, etc.), the applicable reimbursement practices and familiar with automated patient billing systems
* History of successful third-party collection skills and decision-making capabilities, preferably in long term care or retail pharmacy
* Ability to communicate with patients, payors, government offices, etc. through face to face, telephone and written correspondence
* Ability to act independently in a decisive and timely manner
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran