Pre-Arrival Representative

Job Summary:
The Pre-Arrival Representative must demonstrate the philosophy of the University of Pittsburgh Medical Center Health System during the performance of these duties. This role is responsible for a broad spectrum of duties. As a Pre-Arrival Representative you will be responsible for obtaining insurance verification of a patients benefits. The Pre-Arrival Representative will resolve any type of insurance issue such as, a coordination of benefit issue, third party liability issue, Medicare secondary payer questionnaire issue, etc. Pre-Arrival Representative works closely with many departments across the UPMC system, and outside the UPMC umbrella. Good communication skills are essential. The Pre- Arrival representative will provide patients with financial education (Insurance & Self Pay Liabilities) early and often within the Revenue Cycle process to ensure an exceptional patient experience and enable patients to align their clinical care plan with their financial plan.

Responsibilities:

• 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.
• Refrain from disclosing or revealing confidential information to any person and do not access patient or co-worker records (either electronic or files) except as specifically necessary to perform job duties.
• Document appropriate account activity in system(s).
• Attend all mandatory training as defined in UPMC and Revenue Cycle Policies and Procedure manuals.
• Maintain compliance with quality standards.
• Verify insurance benefits with the insurance company or other agency for all admissions, outpatient & surgical procedure. Provide financial education to patients and family on insurance matters, outside resources, patient's financial liability and hospital-billing process to ensure that patient's financial commitment to the institution is arranged for the patient prior to arrival for services. Refer self-pay and other accounts to financial counseling as appropriate. Expand knowledge or current payer lines by staying abreast of changing guidelines and requirements.
• Collect monies, and post payments via NUPAY when applicable.
• All staff members will perform in accordance with system wide competencies behaviors and maintain departmental productivity levels and compliance with quality standards. Proficient working in multiple disciplines.
• *Performs other duties as assigned

• High School Diploma or equivalent required. 
• 1 year of general customer service experience required. 
• Maintain an excellent attendance ad punctuality record. 
• Experience in insurance verification, and customer service preferred. 
• Excellent organizational, interpersonal, and communication skills. Competent in MS Office/PC skills. 
• Knowledge of insurance payers and regulations, managed care contracts and coordination of benefits is required. 
• Maintain an excellent attendance and punctuality record.
  
  Licensure, Certifications, and Clearances:
  Credentialing as a Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM) preferred. 
  
   
• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran