The Pre-Arrival Representative must demonstrate the philosophy of the University of Pittsburgh Medical Center Health System during the performance of these duties. This role is responsible for a broad spectrum of duties, including:
Obtaining insurance verification of patients' benefits.
Resolving insurance issues such as coordination of benefits, third-party liability, and Medicare secondary payer questionnaires.
Working closely with various departments across the UPMC system and outside the UPMC umbrella.
Providing patients with financial education (Insurance & Self Pay Liabilities) early and often within the Revenue Cycle process.
Responsibilities
Perform all duties according to the philosophy and standards of UPMC, embracing system-wide core competencies.
Adhere to UPMC and Revenue Cycle standards of conduct.
Refrain from disclosing confidential information and only access records necessary for 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 insurance companies or other agencies for all admissions, outpatient, and surgical procedures.
Provide financial education to patients and families on insurance matters, outside resources, and hospital billing processes.
Refer self-pay and other accounts to financial counseling as appropriate.
Expand knowledge of current payer lines by staying abreast of changing guidelines and requirements.
Collect monies and post payments via NUPAY when applicable.
Perform in accordance with system-wide competencies and maintain departmental productivity levels.
Perform other duties as assigned.
Qualifications
High School Diploma or equivalent required.
1 year of general customer service 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.
Act 34.
Company Description
UPMC is an Equal Opportunity Employer/Disability/Veteran.