AR Account Specialist, Sr.

Purpose:
Responsible for recovery of self pay balances due. Communicates with patients and outside agencies regarding payment issues. Establishes reasonable payment arrangements, determines charity eligibility, and recommends write-offs according to UPMC Cancer Center policies.

Responsibilities:

• Ability to perform peer to peer training
• Go to person for escalated accounts.
• Advanced knowledge of Microsoft Office.
• Ability to communicate with multiple levels of management
• Perform duties and job responsibilities in a fashion, which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians and other departments within the organization.
• Verify accuracy of payment posting and reimbursement.
• Work with appropriate payer and/or department to resolve any payment discrepancies.
• Understand third party billing and collection guidelines
• Proficient working multiple payers
• Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials.
• Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
• Demonstrate knowledge of the current functionality of the patient accounting system.
• Identify issues and submit corrective action recommendations
• Ability to work independently with minimal supervision
• Ability to understand complex reimbursement issues
• Managed assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards.
• Evaluate and recommend referrals to agency, law firm, financial assistance and bad debt
• Actively engaged in process improvement for efficiency gains.
• Able to review complex issues, determine the root cause issue and present a solution that will result in a cost reduction the majority of the time.
• Meet quality assurance benchmark standards and maintain productivity levels as defined by management.