Manager, Patient Accounts - Follow Up & Denials
Posted on: January 17, 2023
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Jobs Manager, Patient Accounts - Follow Up & Denials
- Job ID: 074538979
- Status: Full-Time
- Regular/Temporary: Regular
- Shift: Day JobThe Patient Accounts team is hiring a Manager of
Patient Accounts!This position will have work from home flexibility
after a 6-9 month training program is completed.Purpose:
This position is responsible for overseeing and monitoring all team
activity as it relates to the timely and accurate follow up of aged
accounts and processing of denials, from Non-Government Payers, for
all Pinnacle Health System hospitals. The manager utilizes work
queues, reports and dashboards to identify and quantify issues
relating to aged or denied claims. This position establishes
financial and production goals, manages the performance evaluation
process and establishes and enforces policies and procedures. They
communicate to stakeholders outside the Patient Accounts Department
regarding process changes needed for timely adjudication of claims
and to be in compliance of payor contracts and requirements.
- The Patient Accounts unit is a service and production-oriented
component of PinnacleHealth Hospitals.
- The centralized business office allows for communication
between work teams.
- Level 4 need to balance a hands-on approach with staff through
managerial responsibilities, which include communication, advocacy,
enforcement of policy, and establishment of performance
- Individuals must be able to succeed in a busy and complex
- Other duties as assigned.
- Special projects as assigned.
- Works to keep staff motivated.
- Writes, updates and enforces policies and procedures under the
direction of the Level 3 management
- Works with Provider Representatives to resolve billing
- Works with IT Analysts to recommend program changes to claims
and processes due to payer requirements or to gain
- Develops processes for handling each type of denial, gives
guidance to staff on processing appeals and seeks assistance from
- Seeks ways for staff to work more effectively and efficiently
to decrease aging and denials.
- Assists Senior Billing Representatives in resolving issues and
responding to staff questions and takes on the resolution of issues
that can't be resolved by the Senior.
- Reviews workload on a daily basis and gives direction to staff
of changes in work assignments to accommodate any shifts in
- Coordinates work sessions with management from other
departments to review and recommend changes to processes, charges
- Monitors denials, determines root causes and communicates
issues with management responsible for the root causes.
- Ensures all activities are in compliance with payer
- Remains current on reading and analyzing payer bulletins and
communications and takes appropriate action when changes are
- Ensures that accounts with credit balances that have a payment
from Medicare, whether primary or secondary, are worked and
overpayments from Medicare are refunded or claim corrections are
initiated, as defined by CMS, to remain in compliance with Medicare
- Establishes and implements procedures to assure accurate and
timely follow up of aged accounts, denials, refunds and credit
- Interviews, hires, disciplines and evaluates the performance of
- Arranges education, training, and other information
- Initiates a quality control process to review staff's work and
give feedback to staff.
- Monitors daily production and gives feedback to staff not
meeting productivity requirements.
- Establishes individual staff goals and expectations.
- Establishes team goals for working aged accounts, denied
claims, refunds and credit balances.Qualifications
- Minimum of 5 years of experience in healthcare
- Minimum of 2 years of management or team lead experience
- Effective written and verbal communication skills.
- Complete understanding of the health care reimbursement
- Manage multiple billing and financial systems and communicate
relevance of reports to staff.
- Compile and present analytics to senior management as they
relate to team performance. -
- A thorough understanding of third-party reimbursement and
- Working knowledge of CPT/HCPCS codes and familiarity with a
hospital Charge Master System.
- Ability to motivate and improve team performance.
- Ability to analyze workload and establish staff performance
- Strong working knowledge of Excel, Word and PowerPoint.
- Preferred Knowledge, Skills and Abilities:
- B.A./B.S. preferred
- Certified Revenue Cycle Executive (CRCE) or Certified Revenue
Cycle Professional (CRCP) desirable.
- Experience with EpicLicensure, Certifications, and
Clearances must be dated within 90 days
- Act 33 with renewal
- Act 34 with renewal
- Act 73 FBI Clearance with renewalUPMC is an Equal Opportunity
Employer/Disability/VeteranCOVID-19 Vaccination Information
Individuals hired into this role must comply with UPMC's COVID
vaccination requirements upon beginning employment with UPMC. Refer
to the COVID-19 Vaccination Information section at the top of this
page to learn more.
-Total RewardsMore than just competitive pay and benefits, UPMC's
Total Rewards package cares for you in all areas of life - because
we believe that you're at your best when receiving the support you
need: professional, personal, financial, and more.Our ValuesAt
UPMC, we're driven by shared values that guide our work and keep us
accountable to one another. Our Values of Quality & Safety ,
Dignity & Respect , Caring & Listening , Responsibility & Integrity
, Excellence & Innovation play a vital role in creating a cohesive,
positive experience for our employees, patients, health plan
members, and community. Ready to join us? Apply today. Current UPMC
employees must apply in HR Direct We are aware of scams targeting
UPMC and other large companies that involve individuals posing as
employees to illegitimately conduct interviews and extend false
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personal information. Please note that UPMC will not communicate
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Yahoo. While some interviews may take place via a video
conferencing service, UPMC Talent Acquisition will not conduct
interviews via Skype or Google Hangouts. UPMC will never ask for or
disburse funds during the recruitment process. If you are hired
into a role with a sign-on bonus or similar incentive, funds will
be paid to you by UPMC after your start date.
Keywords: UPMC, Harrisburg , Manager, Patient Accounts - Follow Up & Denials, Executive , Harrisburg, Pennsylvania
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