UPMC Community Medicine Incorporated is hiring a Full‑time Contact Center Specialist for the Tri Rivers Musculoskeletal Center, Call Center located in Wexford, PA. This position is a Monday‑Friday, Daylight position. No nights, weekends or holidays.
Purpose
The Contact Center Specialist will provide support for the Contact Center activities by serving as the first line of contact for the patient. The Contact Center Specialist acts as an advocate for patients by providing guidance, interpretation and education on scheduling, registration, billing, claim status, and various patient related inquiries. Responsible for efficient and courteous resolution to verbal and written inquiries to ensure internal and external patient satisfaction while maintaining call servicing and quality standards. Typically, functions under the direction of the Supervisor/Manager.
Responsibilities
Answer multi‑line telephone system, with a clear focus on patient satisfaction and first call resolution while scheduling appointments according to the department protocols ensuring the appropriate exam, physician, and timeslot are utilized. Redirect telephone calls and take messages, when appropriate, interacting with the staff and leadership of other departments when necessary. Review, verify and enter the patient's demographic, financial, and insurance information to ensure data integrity. Enter or update information in the appropriate system(s) accurately, verify and revise existing information on patients that have not been interviewed within the past 30 days.
Complete forms, upload, scan, or fax documents as required for patient appointment. Follow up on any incomplete or inaccessible information to assure a completed record. Obtain, verify and correct registration information of new and existing patients. Mail new patient packets prior to scheduled appointment and handle medicine refill requests. Act as an advocate for patients by providing guidance, interpretation, and education on scheduling, registration (directions, parking information, and required preparation for appointment), billing, claims, and various patient related inquiries.
Identify and take action to address patient concerns by utilizing effective decision‑making skills to know when to handle the call, send the call to in‑house clinical staff or send the call to the physician's office to meet the patient's needs. Research, resolve and respond to email, web and telephone billing inquiries from patients and insurance carriers in accordance with departmental protocols. Complete follow‑up on unpaid account balances. Contact guarantors, third‑party payors, and/or other outside agencies for payment of balances due. Establish reasonable payment plans according to department policies; set up payment arrangement in system and monitor payments for consistency and timeliness. Counsel patients on various local, state and federal agencies, which may be available to assist with funding of health care.
Assist patients that call with access issues for their MyUPMC account, telemedicine visit or any other online access concerns. Contact patients to discuss their post‑discharge appointment requirements; follow up and coordinate all appointments for the patient. Review and take action on accounts on aged trial balance reports or in assigned work queue meeting specified dollar and age criteria to ensure lowest number of days possible on accounts receivable. Assign accounts deemed un‑collectible to external collection agencies on a monthly basis. Document all actions taken on a patient account. Review online account history and EOBs to ensure all payers have been billed and to validate the accuracy of payments and adjustments posted.
Identify, review, and research credit balance accounts, potential refunds, adjustments, payment transfers, etc., to bring the account balance to zero. Identify and take action towards resolution of problematic accounts through potential refunds, adjustments, payment transfers, etc. to bring balance to zero. Adhere to Fair Debt Collection Practices Guidelines and understand the laws and regulations applicable to job functions. Perform in accordance with system‑wide competencies/behaviors. Perform other duties as assigned.
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