AR Account Specialist, Senior

Life in Pittsburgh; Pittsburgh (Allegheny County); Hybrid; USD 55,000 - 85,000; Full time

Job summary

UPMC is seeking a Senior AR Account Specialist to support the Revenue Cycle Claims department. The role is based in Pittsburgh, PA with a hybrid schedule and standard Monday–Friday business hours.

The position focuses on recovering self-pay balances and researching insurance coverage through payer portals. You will identify applicable coverage, ensure accurate billing, and collaborate across payer and department teams to resolve issues.

Qualifications

• High school diploma or equivalent with 3 years in billing, registration, or patient services.
• Strong communication and problem-solving abilities.
• Ability to work with payers and maintain confidentiality.

Responsibilities

• Verify payment posting accuracy and resolve discrepancies with payers.
• Understand third-party billing and collection guidelines.
• Proficient with multiple payers and denial management.
• Identify root causes and recommend corrective actions to reduce denials.
• Manage books of business for billing, collections, postings, payments, and adjustments.
• Support process improvements for efficiency and cost reduction.
• Meet quality benchmarks and maintain productivity.
• Provide peer training.

Skills

Communication

Interpersonal skills

Problem solving

Microsoft Office

Education

High school diploma or equivalent

Tools

Payer portals

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

• High school diploma or equivalent and 3 years of billing, registration or patient business services 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 in billing/collections, denials, credit balances and/or various payers.
• 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