UPMC Revenue Cycle is hiring a Manager for Billing and Insurance to join our team to support Revenue Cycle Insurance Collections. This role will work Monday through Friday during business hours with a hybrid work-from-home schedule. This role will be based out of the Quantum One Building in Pittsburgh, PA or another UPMC Revenue Cycle campus. 

In this role, you will be responsible for all Insurance-related Vendors, Pre-transplant Charge Capture, Medicare Bad Debt data preparation and Tobacco audits. The Manager is responsible for developing and implementing process change that results in the reduction of cost and process improvement in the net revenue. The Manager provides direct support, education and functional oversight. The Manager serves as a direct support to Senior Leadership.The Manager must be a highly motivated leader and be able to function in a high-pressure environment and lead the staff through the problem. The Manager will maintain a results-oriented profile to effectively manage the staff and the systems to access, identify, report and resolve the system business issues/needs. Must be extremely dependable, professional, have strong interpersonal skills, be an excellent communicator, maintain the ability to prioritize the workload, and constantly develop the staff. The manager must also be able to minimize the risk to UPMC and constantly be working towards process improvements to minimize problems.

Responsibilities:

Perform on-going analysis to ensure manual processes are minimized and electronic/automated processes are implemented to lead to lower cost and improved net revenue. Provide leadership for Payer Collaborative meetings and Insurance Vendors and/or Pre TX and Medicare/Cost Report Lead the implementation of new-existing initiatives and workflows for process improvements while tracking measurable results. Manage special projects and assignments related to departmental needs and priorities as assigned by leadership. Develop and maintain relationships with leadership, payers, facilities, practices, and other outside professionals and promote a positive customer service environment. Monitor department’s productivity, quality and outcomes to support overall department goal of lowering cost and improving net revenue Perform on-going reviews of processes, market trends and payer/regulatory changes to identify opportunities for process improvement for optimal performance, enhancement of patient satisfaction and keeps the institution from any risk-related issues. Provide reporting and analysis to executive management, and insures all metrics are monitored appropriately. Consults with Executive management and leadership on all facets of the department, including regulatory and payer benchmarks Monitor and communicate the latest regulatory requirements to ensure UPMC facilities/practices are compliant with process requirements. Assist with the design and implement Quality Assurance Program targeting goals, not only accuracy and efficiency, but also high levels of patient and physician satisfaction. Ensure timeliness and accuracy of the processes performed for third party claim submission and billing, ensuring it results in patient satisfaction, maximum collections/reimbursement and optimal revenue cycle and financial performance. Manage the Insurance Collections of new acquisitions as they transition onto Epic/Medipac.  Ensuring, effective and timely cash flow, perform analysis of issues/concerns, participate in identifying and implementing resolutions; as well as, serve as a Revenue Cycle liaison for our implementation team and the departments for insurance-related issues.