Title: Pre-Arrival Representative, Senior

Location: Pittsburgh, PA United States

Job Description:

Purpose:

Do you have experience with medical insurance? Are you looking to grow your career in customer service? UPMC is hiring a full-time Pre-Arrival Representative, Senior to support the Rehabilitation Services department.

This position will work Monday through Friday from 7:30am until 4:00pm. The position is eligible to work from home after training, however in-office coverage would be required as needed.

The Pre-Arrival Representative, Senior is responsible for obtaining insurance verification of a patient's benefits and resolving any type of insurance issue, such as a coordination of benefit issue, third party liability issue, Medicare secondary payer questionnaire issue, etc. They work closely with many departments across the UPMC system and outside the UPMC umbrella. The Pre- Arrival Representative, Senior provides patients with financial education (Insurance & Self Pay Liabilities) early and often within the Revenue Cycle process to ensure an exceptional patient experience and to enable patients to align their clinical care plan with their financial plan. The Pre-Arrival Representative Senior aids and supports co-workers, welcomes new team members, assists with training and providing support/encouragement, and is a mentor for new and veteran insurance verifiers. These employees have good communication skills, the flexibility to adapt to changes in work assignments, the proficiency to verify accounts in any work queue, and the expertise to verify any type of insurance. They also must demonstrate the philosophy of the University of Pittsburgh Medical Center Health System during the performance of these duties.

Responsibilities:

Perform all duties and responsibilities according to the philosophy and standards of UPMC embracing the system wide core competencies. Adhere to the UPMC and Revenue Cycle standards of conduct.
Refrain from disclosing or revealing confidential information to any person and do not access patient or co-worker records (either electronic or files), except as specifically necessary to perform job duties.
Document appropriate account activity in system(s).
Attend all mandatory training as defined in UPMC and Revenue Cycle Policies and Procedure manuals.
Maintain compliance with quality standards.
Verify insurance benefits with the insurance company or other agency for all admissions, outpatient & surgical procedure.
Provide financial education to patients and family on insurance matters, outside resources, patient&#39;s financial liability and hospital-billing process to ensure that patient&#39;s financial commitment to the institution is arranged for the patient prior to arrival for services.
Refer self-pay and other accounts to financial counseling as appropriate.
Expand knowledge on current payer lines by staying abreast of changing guidelines and requirements.
Maintain open, ongoing communication with other departments, payers, vendors, etc. to promote a positive customer service environment.
Assist in providing training to staff and identify opportunities to enhance their knowledge.
All staff members will perform in accordance with system wide competencies behaviors and maintain departmental productivity levels and compliance with quality standards.
Demonstrate effective leadership and time management skills and the ability to prioritize duties.
Collect monies and post payments via NUPAY when applicable.
Proficient working in multiple disciplines.
Perform in accordance with system-wide competencies/behaviors.
Performs other duties as assigned.

Qualifications:

High School Diploma or equivalent required.
2 years of general customer service experience and 6 months call center experience required.
Experience in insurance verification and customer service preferred.
Excellent organizational, interpersonal, and communication skills.
Competent in MS Office/PC skills.
Knowledge of insurance payers and regulations, managed care contracts, and coordination of benefits is required.
Maintain an excellent attendance and punctuality record.

Licensure, Certifications, and Clearances:

Credentialing as a Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM) preferred.
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UPMC is an Equal Opportunity Employer/Disability/Veteran

UPMC Health Plan

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