UPMC Rx Partners is looking for a full time Billing/Collections Specialist to join their dedicated team!

You will 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.

This role will work weekdays, 9:30am - 5pm. One weekend shift, every fifth weekend.

UPMC offers a generous benefits package, an expansive total rewards package, opportunity to grow your career and much more!

Responsibilities:

+ Assist in the development and maintenance of positive working relationships between the receivable team and nursing home facility personnel.

+ Interact with the Nursing Home personnel to ensure the cooperative flow of insurance and financial information on patients.

+ Guide and motivate people and have the expertise to recognize, analyze and resolve problems and inefficiencies in the billing/collection process.

+ Communicate pertinent reimbursement issues in a timely manner to Supervisor, CEO and Nursing Home.

+ Adhere to the UPMC Health System and Patient Business Services Standards of Conduct.

+ Observe both UPMC HS and Rx Partners-LTC policies and procedures.

+ Maintain both yourself and your work in a manner consistent with a professional environment.

+ Analyze systems and procedures that affect the efficient billing and collection of accounts and recommend and implement needed changes.

+ Provide assistance to other department personnel as required through the direction of your supervisor.

+ Negotiate discounts and/or settlements according to the guidelines established and refer any exceptions to management as appropriate.

+ Adhere to Fair Debt Collection Practices Act guidelines.

+ Facilitate prompt resolution of accounts by communicating with all concerned parties, including third-party insurers, nursing home facilities and patients and/or their representatives.

+ Attend compliance training program as defined in the compliance training policy and assist in monitoring compliance within area of responsibility.

+ Maintain logs for month-end reporting purposes, such as potential collection problem accounts, reimbursement issues, high dollar accounts, etc.

+ Pursue the collection of pharmacy accounts from the point of adjudication to the final resolution of the account.

+ Analyze patient accounts with respect to potential problems and develop an appropriate collection strategy.

+ Pursue information in an aggressive, yet highly professional manner.

+ A Bachelor's degree; or

+ 3-5 years experience as a retail pharmacy technician or

+ 3-5 years experience in pharmacy accounts receivable environment

+ 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, preferably in long term care or retail pharmacy

+ 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 mannerLicensure, Certifications, and Clearances:

+ Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran