AR Account Specialist

UPMC; Pittsburgh (Allegheny County); On-site; USD 45,000 - 65,000; Full time

Job summary

UPMC is seeking an AR Account Specialist to support revenue cycle operations by managing account follow-up, researching and resolving balances, and ensuring timely and accurate billing.

Ideal candidates have healthcare billing experience, familiarity with third-party payor guidelines, and strong computer skills. The role requires detail orientation and ability to work independently in a fast-paced environment.

Qualifications

• 2+ years in healthcare billing, registration, or patient business services (or 5 years in a business office)
• Knowledge of medical terminology, third-party payor guidelines, and reimbursement practices
• Good computer skills including spreadsheet and word processing

Responsibilities

• Evaluate and refer to agency, law firm, financial assistance and bad debt
• Meet QA benchmarks and maintain productivity levels
• Demonstrate knowledge of patient accounting system functionality
• Peer-to-peer training capability
• Identify issues and submit corrective action recommendations
• Verify accuracy of payment posting and reimbursement; resolve discrepancies with payers
• Understand complex reimbursement issues
• Manage multiple disciplines concurrently
• Identify root causes of denials and assist in appeal processes
• Engage in process improvements for efficiency gains
• Manage assigned book of business for timely billing, collections, postings, payments, adjustments
• Work independently with minimal supervision
• Understand third party billing and collection guidelines
• Uphold service excellence standards towards patients and staff

Skills

Detail-oriented

Organized

Problem solving

Communication

Education

High School Diploma or equivalent + 2 years healthcare billing

Bachelor's degree + 1 year business office

Tools

Microsoft Excel

Word processing

Job description

Join our team as an AR Account Specialist and play an important role in supporting accurate and timely revenue cycle operations. You’ll manage account follow-up, research and resolve outstanding balances, and work to ensure accounts are processed efficiently and accurately. This is a great opportunity for someone who is detail-oriented, organized, and enjoys problem-solving in a fast-paced environment.

Purpose

Responsible for all fiscal functions necessary to ensure the prompt and correct payment to the provider of all monies owed by insurers. Communicate with insurance companies, patients, physicians, and vendors regarding payment issues and recommend write-offs according to UPMC policies. Responsible for working edits/accounts, reviewing posting and balancing of payment/denial and adjustment transactions necessary for closing accounts. Responsible for account balances according to their respective payer when applicable, and for timely and accurate billing in accordance with Third Party regulations.

Responsibilities

• Evaluate and recommend referrals to agency, law firm, financial assistance and bad debt
• Meet quality assurance benchmark standards and maintain productivity levels as defined by management.
• Demonstrate knowledge of the current functionality of the patient accounting system
• Ability to perform peer to peer training
• Identify issues and submit corrective action recommendations
• Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies.
• Ability to understand complex reimbursement issues
• Proficient working multiple disciplines
• Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials. Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
• Actively engaged in process improvement for efficiency gains. Able to review complex issues, determine the root cause issue and present a solution
• Managed 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.
• Ability to work independently with minimal supervision
• Understand third party billing and collection guidelines
• Perform duties and job responsibilities 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.

HS/Equivalent and 2 years of healthcare billing, registration, or patient business services or 5 years experience in a business office setting OR BS and 1 year experience in a business office setting OR equivalent combination of education and experience required. Knowledge of medical terminology, third party payor guidelines and reimbursement practices, and available financial resources for payment of balances due. Good computer skills, including spreadsheet application and word processing.

Licensure, Certifications, and Clearances

• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran