Billing/Collections Specialist - CCP Hybrid at UPMC

Wexford, Pennsylvania, United States -

Full Time

Start Date

Immediate

Expiry Date

18 May, 26

Salary

0.0

Posted On

17 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Billing, Collections, EPIC, Third-Party Payor Analysis, Insurance Verification, Account Resolution, Financial Decision Making, System Analysis, Negotiation, Compliance Monitoring, Debt Collection Practices, Communication, Problem Solving, Medical Billing, Accounts Receivable

Industry

Hospitals and Health Care

Description

Are you passionate about helping kids be their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Billings/Collections Specialist to support the office in a hybrid role. EPIC experience preferred. Purpose: Provide for the timely control, submission, collection, and analysis of all third-party payor accounts. Provide for the on-going analysis of insurance verification, billing and collection efforts to insure a timely resolution of accounts. Make sound financial decisions to facilitate the resolution of third-party accounts based on the information gathered from such sources at third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Billing/Collections Specialist. Responsibilities: Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes. Communicate pertinent reimbursement issues in a timely manner to Supervisor. Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc. Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate. Observe UPMC HS policies and procedures. Maintain both yourself and your work in a manner consistent with a professional environment. Provide assistance to other department personnel as required through the direction of your supervisor. Pursue information in an aggressive, yet highly professional manner. Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process. Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility. Adhere to the UPMC Health System and Patient Business Services Standards of Conduct. Pursue the collection of accounts from the point of adjudication to the final resolution of the account. Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers and patients and/or their representatives. Interact with office personnel to ensure the cooperative flow of insurance and financial information on patients. Adhere to Fair Debt Collection Practices Act guidelines. Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy. Assist in the development and maintenance of positive working relationships between the receivable team and clinical office personnel. Bachelor's degree in a relevant field, or 3-5 years of experience in a medical billing department and/or accounts receivable environment. Knowledge of third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial) and reimbursement practices Experience with automated patient billing systems Successful third-party collections and decision-making in primary care or inpatient billing Strong communication skills for interacting with patients, payors, and government offices Ability to act independently and make timely decisions Licensure, Certifications, and Clearances: Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

Responsibilities

The specialist is responsible for the timely control, submission, collection, and analysis of all third-party payor accounts, ensuring ongoing analysis of verification, billing, and collection efforts for timely resolution. Key duties include analyzing systems, negotiating settlements, maintaining logs for reporting, and pursuing collections from adjudication to final resolution.