Hybrid Pharmacy Billing & Collections Specialist

UPMC; Pittsburgh (Allegheny County); Híbrido; USD 42.000 - 68.000; Jornada completa

Descripción de la vacante

UPMC Community Pharmacy in Pittsburgh, PA is hiring a full-time Billing/Collections Specialist for a hybrid role (approx. 50%–90% remote).

The position focuses on timely billing, collection, and analysis of third-party payer accounts for retail pharmacy services, serving as a key liaison among pharmacies, insurers, patients, and internal stakeholders. The ideal candidate will possess strong analytical and communication skills and thrive in a fast-paced healthcare environment, supporting

Responsabilidades

• Assist in the development and maintenance of positive working relationships between the receivable team and retail pharmacy personnel.
• Interact with retail pharmacy 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 the Supervisor, Managers, and Director.
• Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.
• Observe both UPMC Health System and retail pharmacy policies and procedures.
• Maintain 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 established guidelines 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, retail pharmacy personnel, patients, and/or their representatives.
• Attend compliance training programs as defined in the compliance training policy and assist in monitoring compliance within your 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 through final resolution.
• Analyze patient accounts to identify potential issues and develop appropriate collection strategies.
• Pursue information in an assertive, yet highly professional manner.

Descripción del empleo

UPMC Community Pharmacy in Pittsburgh, PA is hiring a full-time Billing/Collections Specialist for a hybrid role (approx. 50%–90% remote).

The position focuses on timely billing, collection, and analysis of third-party payer accounts for retail pharmacy services, serving as a key liaison among pharmacies, insurers, patients, and internal stakeholders. The ideal candidate will possess strong analytical and communication skills and thrive in a fast-paced healthcare environment, supporting