Accounts Receivable Specialist II, Physician Billing.

Exemption Status: Non-Exempt

Hiring Range: $20.94 - $29.27. Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule

• Monday through Friday
• 40 flexible scheduled hours per week
• Day Shift (8 Hours)

About the Role

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where you can build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other.

Responsibilities

• Follow-up of complex surgical/procedural/multidisciplinary specialty claims for payments, including coding and analyzing claims and claim payments/rejections.
• Contact insurance companies, while working detailed reports, to secure outstanding payments (e.g., telephone calls, websites, written appeals).
• Review complex rejections in assigned payors and plans to determine validity of rejections and take appropriate action to resolve.
• Monitor changes in reimbursement policies, including payor fee schedule reconciliation.
• Perform special projects as assigned by manager or supervisor, defining problems, determining work sequence, and summarizing findings.
• Calculate and post adjustments based on third-party reimbursement guidelines and contracts.

Requirements

• High School Diploma (required).
• Two years of previous Revenue Cycle knowledge, including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding, and/or 3rd party reimbursement.
• Knowledge of multiple third-party regulations, ICD, CPT, and HCPCS coding and modifier assignment.
• Knowledge of billing and reimbursement practices/requirements of major third-party payors in Massachusetts.
• Knowledge of medical terminology, anatomy & physiology, and disease process.
• Ability to organize and prioritize work to meet strict deadlines.
• Computer skills to include mainframe, PC applications, and Excel.
• Self-motivated, service-oriented, and excellent communication skills (written and oral).

Qualifications

• Physician coding certification is desired.
• Preferred: Three years of physician or medical billing experience involving complex surgical/procedural/multidisciplinary specialties.

Benefits

• This position may have a signing bonus available; eligibility will be confirmed during the interview process.