Payment Specialist I

UPMC Revenue Cycle is hiring a Payment Specialist I to join our team. The Payment Specialist I will work Monday through Friday during business hours from the US Steel Tower in Pittsburgh, PA. After training, a hybrid work schedule of working from home four days a week will be possible.

In this role, you will be responsible for a ccurate data entry, balance and post payments/denial/correspondence for all designated UPMC entities. You will also be assigned to prepare all documentation related to receivables or transfers as required by the department, and to image paper documents.

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Responsibilities:

• Understand payment posting and the relationship between co-pays, deductibles, co-insurance, allowances and payments so that the account balance is accurate after payment is posted. Consistently meet departmental productivity standards as set by management.
• Ability to navigate on the various payer websites.
• Maintain a variety of entry-level system-generated work queues on a daily basis.
• Recognize Bad Debt transactions and supply proper documentation to ensure bad debt payment is posted accurately into any and all patient billing systems or legacy master spreadsheets.
• Apply undistributed payments on any and all patient billing systems, following established guidelines. Understand how to scan and record payment and denial data to image to the imaging system. Know how to delete a mis-scanned batch. Log all work so that it can be balanced the next day.
• Prepare documentation for payments that must be transferred to another UPMC entity, or refunded to payer. Ensure accurate posting of payments that belong to another UPMC entity or prepare appropriate documentation so that funds can be transferred or refunded.
• Once bank deposits and payments are in balance, provide a summary to the cash accounting staff to make entries. Post and/or code non-cash data accurately by selecting the standard code to designate the reason (payment denial, admission approval, refund request, etc). Post memo or contractual adjustment if warranted, and close the receivable to the next payer if warranted.
• Key payment data from lockbox work, capturing all relevant data, including payer remark codes that would assist the Billing Department to determine how to follow up on a denial. Verify that funds are in the bank before posting. Thoroughly research questionable/unidentified payments in order to post properly. Contact insurance carriers, completes documentation forms and follow up on any amounts posted to suspense, UTL, or clearing accounts.