Payment Specialist I-Living & Donation Transplant Team

Payment Specialist

The Living & Donation Transplant Team is looking for a knowledgeable and motivated Payment Specialist to support the complex financial processes associated with living donor and organ transplant services.

The ideal candidate brings a strong understanding of healthcare payment workflows, exceptional attention to detail, and a patient- and donor-centered mindset. This position plays an essential role in supporting life?saving transplant care and ensuring a seamless financial experience for donors and recipients alike.

Join a team where your work directly supports patients, donors, and families during some of the most meaningful moments of their lives.

Purpose: Accurate data entry, balance and post payments/denial/correspondence for all designated UPMC entities. Also assigned to prepare all documentation related to receivables or transfers as required by the department, and to image paper documents. Responsibilities:

• Understand payment posting and the relationship between co-pays, deductibles, co-insurance, allowances and payments so that the account balance is accurate after payment is posted. Consistently meet departmental productivity standards as set by management.
• Ability to navigate on the various payer websites.
• Maintain a variety of entry-level system generated work queues on a daily basis.
• Recognize Bad Debt transactions and supply proper documentation to ensure bad debt payment is posted accurately into any and all patient billing systems or legacy master spreadsheets.
• Apply undistributed payments on any and all patient billing systems, following established guidelines. Understand how to scan and record payment and denial data to image to the imaging system. Know how to delete a mis-scanned batch. Log all work so that it can be balanced the next day.
• Prepare documentation for payments that must be transferred to another UPMC entity, or refunded to payer. Ensure accurate posting of payments that belong to another UPMC entity or prepare appropriate documentation so that funds can be transferred or refunded.
• Once bank deposit and payments are in balance, provide summary to cash accounting staff to make entries. Post and/or code non-cash data accurately by selecting the standard code to designate the reason (payment denial, admission approval, refund request, etc). Post memo or contractual adjustment if warranted, and close the receivable to the next payer if warranted.
• Key payment data from lockbox work, capturing all relevant data including payer remark codes that would assist the Billing Department to determine how to follow up on a denial. Verify that funds are in the bank before posting. Thoroughly research questionable/unidentified payments in order to post properly. Contact insurance carriers, completes documentation forms and follows up on any amounts posted to suspense, UTL, or clearing accounts. Items posted to suspense, UTL, or clearing counts must be resolved within 7 days, or notice provided to supervisor of the reason for the extended delay.

High school graduate. Two to three years' experience in an accounts receivable environment, preferably in the health care or insurance field. Good data entry skill and familiarity with personal computers and software such as but not limited to Excel. Analytical skills and proficiency with math operations such as balancing a checkbook. Basic accounting knowledge is essential.

Licensure, Certifications, and Clearances: Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran