AR Account Specialist, Senior

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 65,000 - 90,000; Full time

Job summary

UPMC is seeking a Senior AR Account Specialist in Pittsburgh, PA, to support the Revenue Cycle Claims department. The role offers a hybrid schedule with weekday business hours.

You will recover self-pay balances, review accounts daily, and research insurance coverage through payer portals to ensure accurate billing and reimbursement.

Qualifications

• Verify payment postings and resolve discrepancies with payers.
• Understand third-party billing and collection guidelines.
• Work with multiple payers efficiently.
• Identify root causes of denials and propose corrective actions.
• Assist in claim appeals and follow-up per Revenue Cycle policy.
• Understand current patient accounting system functionality.
• Ability to work independently with minimal supervision.
• Manage books of business ensuring timely billing, collections, postings and adjustments.

Responsibilities

• Verify accuracy of payment posting and resolve discrepancies with payers.
• Understand third-party billing and collection guidelines.
• Proficient working with multiple payers.
• Identify root cause issues and recommend corrective action steps to eliminate future occurrences of denials.
• Demonstrate knowledge of the patient accounting system and submit corrective action recommendations.
• Ability to work independently with minimal supervision.
• Understand complex reimbursement issues.
• Manage assigned books of business by ensuring the timeliness and accuracy of billing, collections, postings, payments and adjustments.

Skills

Payment posting

Denials analysis

Payer portals

AR management

Microsoft Office

Tools

Patient accounting software

Job description

UPMC is hiring a Senior AR Account Specialist to support the Revenue Cycle Claims department. This position will work Monday through Friday during business hours. This role will be based in Pittsburgh, PA, with the ability to work a hybrid schedule.

In this role, you will be responsible for recovering self-pay balances by reviewing account files daily and researching insurance coverage through payer portals. As the AR Account Specialist Senior, you will identify applicable coverage and ensure accounts are billed accurately.

Responsibilities:

• Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies.
• Understand third-party billing and collection guidelines
• Proficient working with multiple payers
• 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.
• Demonstrate knowledge of the current functionality of the patient accounting system. Identify issues and submit corrective action recommendations
• Ability to work independently with minimal supervision
• Ability to understand complex reimbursement issues
• Manage assigned books of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards.
• Evaluate and recommend referrals to agency, law firm, financial assistance, and bad debt
• Actively engage in process improvement for efficiency gains. Able to review complex issues, determine the root cause issue and present a solution that will result in a cost reduction the majority of the time.
• Meet quality assurance benchmark standards and maintain productivity levels as defined by management.

• Ability to perform peer to peer training

• Advanced knowledge of Microsoft Office
• Ability to communicate with multiple levels of management