UMass Memorial Health · 2 days ago

AR Specialist II, Physician Billing.

Worcester, MA Worcester Business Center

Full-time

Remote

Entry, Mid Level

2+ years exp

Maximize your interview chances

DiabetesEducation

Insider Connection @UMass Memorial Health

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

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.

Makes appropriate payor and plan changes to secondary insurers or responsible parties.

Inputs missing data as required and corrects registration and other errors as indicated.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Revenue Cycle knowledgeICD codingCPT codingHCPCS codingBilling practicesMedical terminologyAnatomy & physiologyComputer skillsPhysician coding certificationService oriented

Required

High School Diploma

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.

Must be self-motivated, service oriented and have excellent communication skills (written and oral).