Transplant Credit Analyst

Description

UPMC Corporate is hiring a Transplant Credit Analyst to join our team at Quantum I.  This posiiton will work Monday through Friday with occasional on call hours.  The position will work from home after training has been completed. 

The Transplant Credit Analyst is responsible for the timely and accurate financial verification and analysis of all potential transplant patients. The Transplant Credit Analyst will be responsible for the detailed verification of inpatient and outpatient medical benefits, as well as, specific transplant and transplant-related coverage. Based on the information gathered from such sources as third-party insurers, physicians, hospital personnel, governmental agencies, lawyers and patients, the Transplant Credit Analyst will be responsible for making sound decisions related to the financial clearance of potential transplant patients. Must be dependable, professional, have strong interpersonal skills, be an excellent communicator and have the ability to prioritize the workload.

Are you up for the challenge?  If so, apply today!

Responsibilities:

• Attend all mandatory training and meetings as defined in UPMC and Revenue Cycle Policies and Procedures manuals.
• Refrain from disclosing or revealing confidential information to any person and do not access patient or coworker records (either electronic or files) except as specifically necessary to perform job duties.
• Perform the financial clearance on potential transplant candidates and donors by obtaining transplant related benefits for Hospital, Outpatient, Physician and Pharmacy services based on the Credit Analyst Procedure Manual.
• Perform benefit education and financial counseling on potential out of pocket transplant related expenses with patients during clinic appointments and subsequent discussion via telephone on an as needed basis.
• Monitor and update candidate and donor information in the appropriate source systems on a routine basis which may affect the financial status of the patient.
• Maintain departmental productivity levels.
• Obtain and maintain a complete understanding and working knowledge of all relevant systems used by the department.
• Maintan compliance with quality standards.
• Gather and analyze financial data concerning the admission of potential transplant patients from such sources as physicians, coordinators and hospital departments.
• Perform all duties and responsibilities according to the philosophy and standards of UPMC, embracing the system-wide core competencies. Adhere to the UPMC and Revenue Cycle Standards of Conduct.
• Act as a liaison between the various transplant offics, Quality payer services liaison and Contracting.
• Demonstrate ability to understand reason for patient visit and apply decision making ability to schedule an appointment with the correct sub-specialist by obtaining medical information/diagnosis in order to adequately meet the patient's needs and allow f
• Ensure effective communication to patients regarding scheduling and call details, give basic information to patients (directions, parking information, and required preparation for appointment).
• Make decisions independently and take initiative to find answers to questions. Appropriately triage phone calls to or from clinical and other areas.
• Ensure effective communication and call escalation to appropriate personnel; includes thorough and accurate documentation of telephone encounter.
• Provide support to supervisor/manager in the instruction of training new staff in order to maintain a high quality of service to the patient and the department.

Qualifications

• HS/Equivalent and five years of experience OR BS and one year of experience required
• Strong experience in insurance verification and accounts receivable management (preferably in the health care field) is preferred.
• Strong analytical skills utilizing PC-based software applications are recommended.
• Must have strong oral and written communication skills and ability to develop and maintain a working environment conducive to the education of the various clinical areas regarding the financial clearance process.
• Must be able to coordinate the insurance verification and accounts receivable collection functions.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary : $18 - $30