Billing Collections Specialist

Job Summary:
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:

• Adhere to Fair Debt Collection Practices Act guidelines.
• Pursue information in an aggressive, yet highly professional manner.
• Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.
• Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, and patients and/or their representatives.
• Deposits payments at bank in a secure and timely manner as needed.
• Pursue the collection of accounts from the point of adjudication to the final resolution of the account.
• 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.
• Assist in the development and maintenance of positive working relationships between the receivable team.
• Interact with personnel to ensure the cooperative flow of insurance and financial information on patients.
• Provide assistance to other department personnel as required through the direction of your supervisor.
• Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.
• Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.

• High school diploma or equivalent required. 
• Prefer Associates Degree in Business/Healthcare or 2 years experience as a secretary. 
• 3-5 years experience in accounts receivable environment OR equivalent combination of education and experience. 
• KNOWLEDGE, SKILLS & ABILITIES & INTERPERSONAL/LANGUAGE SKILLS Strong interpersonal, communication and collection skills required. 
• Knowledge of all third-party payors (Medicare, Blue Cross, Medical Assistance, Commercial, etc.), the applicable reimbursement practices and familiar with automated patient billing systems. 
• History of successful third-party collection skills and decision-making capabilities 
• Ability to communicate with patients, payors, government offices, etc. through face to face, telephone and written correspondence. 
• Ability to act independently in a decisive and timely manner 
• Knowledge of ICD-9 and CPT Coding preferred. 
• Knowledge of medical terminology preferred. 
• Must possess good working knowledge of grammar and general office procedures. 
• Must possess a good working knowledge of word processing and spreadsheet software including Word and Excel. 
• The ability to use office machines (fax, copier, mail, etc.) preferred. 
• Must complete CRS Orientation, Facility-specific Orientation, and Department Specific Orientation(s) where appropriate. 
• Must possess the ability to provide customer services of the quality expected of CRS employees. 
• Must complete all mandatory competencies for system, CRS business unit and/or facility. 
• Must be organized and possess good time management skills and able to prioritize heavy workload.
• Must possess effective written and verbal communication skills. 
• Must have strong interpersonal skills including the ability to interact with all personalities
  
  Licensure, Certifications, and Clearances:
   
• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran