Senior Revenue Cycle Specialist - Payments & Denials

UPMC; Pittsburgh (Allegheny County); On-site; USD 65,000 - 85,000; Full time

Job summary

UPMC is seeking an Account Representative, Senior to handle all fiscal functions ensuring prompt and accurate payment to the hospital from insurers and patients. You will oversee claim submission, posting, and reconciliation.

You will communicate with payers, patients and physicians about payment issues, establish payment arrangements, review denials, and mentor staff on best practices in revenue cycle management.

Responsibilities

• Demonstrate service excellence with patients, visitors, staff, peers, physicians and other departments within the organization
• Ability to work with multiple payers
• Verify accuracy of payment posting and reimbursement; resolve discrepancies with appropriate payer/department
• Identify root causes of denials and recommend corrective actions to prevent recurrence
• Assist in claim appeal process and follow-up per Revenue Cycle policies
• Manage assigned book of business ensuring timely and accurate billing, collections, postings, payments and adjustments
• Evaluate referrals to agency, law firm, Financial Assistance and Bad Debt
• Understand third-party billing and collection guidelines
• Demonstrate knowledge of patient accounting systems functionality
• Identify issues and submit corrective action recommendations
• Work independently with minimal supervision
• Meet QA benchmarks and maintain productivity levels as defined by management

Job description

UPMC is seeking an Account Representative, Senior to handle all fiscal functions ensuring prompt and accurate payment to the hospital from insurers and patients. You will oversee claim submission, posting, and reconciliation.

You will communicate with payers, patients and physicians about payment issues, establish payment arrangements, review denials, and mentor staff on best practices in revenue cycle management.