AR Specialist II, Physician Billing

Exemption Status: Non-Exempt

Hiring Range: $20.94 - $33.59. 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
• 8-hour shift (6:00 AM – 6:00 PM)
• 40 hours per week
• Day Shift

Responsibilities

• Follow-up of complex surgical, procedural, and multidisciplinary specialty claims for payments, including coding and analyzing claims and claim payments/rejections.
• Contact insurance companies, using detailed reports, to secure outstanding payments via telephone calls, websites, and written appeals.
• Review complex rejections in assigned payors and plans to determine validity 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.
• Make appropriate payor and plan changes to secondary insurers or responsible parties.
• Input missing data as required and correct registration and other errors as indicated.

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 third-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 including mainframe, PC applications, and Excel.
• Self-motivated, service-oriented, and excellent communication skills (written and oral).

Qualifications

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

Benefits

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

About the Organization

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. 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. Everyone plays an important part, every day.

We strive to make respect a part of everything we do. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player, and Be Kind.