Account Representative Sr- UPMC Western Maryland

About the position The Account Representative, Senior at UPMC Western Maryland is responsible for managing all fiscal functions related to the timely and accurate payment of amounts owed to the hospital by insurers and patients. This hybrid role involves both in-office and remote work, focusing on ensuring claims are submitted correctly, resolving payment issues, and mentoring junior staff. Responsibilities • Perform duties in alignment with UPMC Health System's service management philosophy. , • Verify accuracy of payment posting and reimbursement. , • Work with payers and departments to resolve payment discrepancies. , • Identify root causes of issues and recommend corrective actions to prevent future denials. , • Assist in the claims appeal process and follow up according to Revenue Cycle policies. , • Manage an assigned book of business ensuring timely and accurate billing and collections. , • Evaluate and recommend referrals to agencies, law firms, Financial Assistance, and Bad Debt. , • Understand third-party billing and collection guidelines. , • Demonstrate knowledge of patient accounting systems. , • Identify issues and submit corrective action recommendations. , • Work independently with minimal supervision. , • Meet quality assurance benchmarks and maintain productivity levels. Requirements • Must have 1 year of claims/billing/collections experience; OR 4 years in a business office setting; OR a Bachelor's Degree; OR an equivalent combination of education and experience. , • Excellent interpersonal, organizational, communication, and problem-solving skills. , • Ability to communicate effectively with patients, payers, and outside agencies through various means. , • Prior experience with personal computers, electronic calculators, and office equipment. , • Multi-disciplined in billing, collections, denials, and credit balances. Nice-to-haves • Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology. , • Familiarity with third-party payer guidelines and reimbursement practices. , • Available financial resources for payment of balances due.

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