Job Information
UPMC Payor Specialist in Harrisburg, Pennsylvania
Purpose:
The Payor Specialist role involves a blend of clerical, secretarial, and payor-related tasks. You’ll be part of a warm and welcoming team that fosters a wonderful working culture and environment. Our typical work hours are 8:30 AM to 5:00 PM, Monday through Friday, with occasional weekend shifts (currently once every 3 months). This position is on site in Harrisburg, PA.
Responsibilities:
Notify payors of admissions and discharges.
Communicate payor issues and concerns to care managers, documenting interactions in Canopy.
Assist with denial management processes, including concurrent and retrospective denials and appeals.
Provide prompt payor feedback to care managers and social workers to optimize patient care.
Obtain payor benefit verification for post-acute services.
Maintain authorization/certification information in Canopy and Medipac System.
Support the payer call center for authorization requests.
Adhere to hospital policies and demonstrate Service Excellence behaviors.
High school diploma or equivalent and one year of claims, billing, or collections experience
OR 4 years in a business office setting
OR Bachelor's degree
OR equivalent combination of education and experience.
Excellent communication skills, both written and verbal.
Coordination and interpersonal skills along with the ability to exercise independent judgment.
Thorough knowledge of Microsoft Work, Excel, Access and PowerPoint is required. Licensure, Certifications, and Clearances:
Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran