[Hiring] Accounts Receivable Specialist II, Physician Billing @UMass Memorial Health

Role Description

Responsible for follow-up of complex surgical/procedural/multidisciplinary specialty claims for payments including coding and analyzing claims and claim payments/rejections.

• Contacts insurance companies, while working detailed reports, to secure outstanding payments, i.e. telephone calls, websites, written appeals.
• Reviews complex rejections in assigned payors and plans to determine validity of rejections and take appropriate action to resolve.
• Monitors changes in reimbursement policies, including payor fee schedule reconciliation.
• Performs special projects as assigned by manager or supervisor defining problems, determining work sequence and summarizing findings.
• Calculates and posts adjustments based on third party reimbursement guidelines and contracts.

Qualifications

• 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 (Required)
• 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.
• Must be self-motivated, service oriented and have excellent communication skills (written and oral).
• Physician coding certification is desired (Preferred)
• Three years of physician or medical billing experience involving complex surgical/procedural/multidisciplinary specialties (Preferred)

Requirements

• Non-Exempt
• Hiring Range: $20.94 - $29.27
• Schedule Details: Monday through Friday
• Scheduled Hours: 40hrs flexible
• Shift: 1 - Day Shift, 8 Hours (United States of America)
• Cost Center: 99940 - 5442 Primary Care Pod Ar
• Union: SHARE (State Healthcare and Research Employees)
• This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Benefits

• Exceptional patient care, academic excellence, and leading-edge research.
• Opportunity to build a career in a premier health system.
• Supportive work environment with over 20,000 employees working together.