Charge Processing Specialist II- Revenue Cycle

1 week ago

Pittsburgh, Pennsylvania, United States UPMC Full time

Purpose:

UPMC Corporate Services is hiring a full-time Charge Processing Specialist II- Revenue Cycle to support the Charge Management department. The position would work Monday through Friday during daylight hours. The position is eligible to work from home after training.

The Charge Processing Specialist II ensures managed care requirements are met by accessing the referral system and attaching the pre-loaded authorization to the charge being processed. The direct entry of the managed care referral into Cadence will be required if the authorization is attached to the charge document upon submission to the Charge Processing Department.

Responsibilities:

  • Assist in the processing of charge correction requests and document types of corrections performed, in addition to verifying the validity of the requests received.
  • Ensure physician charges are applied to the correct account by verifying information indicated on the charge document against the system information.
  • Ensure the appropriate modifier is attached at the charge entry level for Medicare non-covered and limited coverage service and for resident participation.
  • Document and resolve all problem charge vouchers on a daily basis.
  • Process charge documents into the Epic system and maintain minimum productivity levels.
  • Balance charges entered at the end of the day, each day.
  • Verify all charge batches entered are processed with the correct revenue location.
  • Assist in the processing of charges, which includes institutional accounts, charge override services and payment transfers for cosmetic services.
  • Coordinate the exchange of information/documentation with other practice plans or ancillary departments.
  • Perform limited ICD-9 and CPT-4 coding from charge slips, encounter forms, or source documentation.
  • Verify the appropriate Place of Service (POS) code is submitted in relation to the rendered procedure Type of Service (TOS) at the charge entry level based on the payer specific requirements.
  • Ensure the charges for bilateral services are processed in accordance with payer specific guidelines.

  • Review coding and charges for accuracy and completeness.

  • High School diploma/Equivalent and 1 year of claims/billing/collections experience OR 2 years of work experience required.

  • Strong verbal, telephone, and written correspondence skills.
  • Knowledgeable of medical terminology, cash collection and application, ICD-9/CPT-4 coding, and third-party payer billing and reimbursement practices.
  • Ability to effectively problem solve.
  • Prior working experience on personal computers and various office equipment.

Licensure, Certifications, and Clearances:
- Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

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