Price Estimate Analyst

at  UPMC

JOB SUMMARY:

Design, develop, and analyze system edits, payer and provider system maintenance, electronic submission errors and financial/statistical reports that will support the operational needs of the central business office. Provide weekly/monthly summaries to the management team.

• Work Location/ Address: UPMC West Shore, 1995 Technology Parkway, Mechanicsburg, PA 17050
• Hours per week: Fulltime 40 hours per week
• Shift times: 7:30a-4:00p during training. When training is complete have the option to stay 7:30a-4:00p or move to 8:00a-4:30p
• Days: Monday-Friday

• Perform duties and job responsibilities in a manner which promotes the core values of UPMC (Quality and Safety, Dignity and Respect, Caring and Listening, Excellence and Innovation, Responsibility and Integrity) in all consumer and UPMC interactions.
• Attend all mandatory training as defined in UPMC and Revenue Cycle Policies and Procedures manuals.
• Refrain from disclosing or revealing confidential information to any person and do not access patient or coworker records (either electronic or files) except as specifically necessary to perform job duties.
• Liaise with physician offices, internal departments and insurance companies to develop accurate estimate if requests are vague or incomplete.
• Deliver Price Estimates to patients in a courteous and knowledgeable manner, providing clarification about the patient’s benefits if requested.
• Maintain compliance with quality standards.
• Utilize the price estimate software where applicable.
• Maintain departmental productivity levels.
• Create timely Price Estimates by identifying and analyzing comparable patient examples, utilizing insurance website or hotlines to confirm eligibility and benefits, reviewing appropriate fee schedules to determine correct charges and applying all information to ascertain patient liability.
• High School diploma or equivalent and 5 years of experience,
• OR Bachelor’s degree and 1 year of experience.
• Bachelor’s degree in Business Administration, Finance or Accounting preferred.
• Strong PC and computer skills are required (Excel, Access and Crystal report writing).
• Must possess strong analytical and problem-solving skills.
• Familiarity with large-scale, automated patient billing systems (e.g., Medipac, EPIC), medical terminology, and fee schedules and coding (e.g., CPT/HCPCS) preferred.
• Strong analytical and problem-solving skills, organization and time management.
• Previous experience with insurance verification and benefit application preferred.
• Must develop and manage positive working relationships with colleagues, management, 3rd party payers, patients or their representatives, physicians and hospital leadership.
• Good oral and written communication skills required.LICENSURE, CERTIFICATIONS, AND CLEARANCES:UPMC is an Equal Opportunity Employer/Disability/Veteran