UMass Memorial Health · 5 months ago
PRE-BILLING & CLAIMS ASSOC I (DAYS)
Worcester, MA
Full-time
Onsite
Entry Level
$19/hr - $30/hr
1+ years expUMass Memorial Health is a premier health system in Central Massachusetts, dedicated to exceptional patient care and academic excellence. They are seeking a Pre-Billing & Claims Associate to support the timely and accurate submission of claims, ensuring adherence to guidelines and resolving claim edits effectively.
DiabetesEducationHealth CareHospitalMedicalPersonal Health
Responsibilities
Prioritizes standards and guidelines to perform pre-billing and claims submission processes utilizing assigned work queues
Sorts, distributes and processes primary and secondary paper claims. Ensures appropriate attachments are included leveraging available technology if possible. Documents action taken as appropriate in the Hospital Billing revenue cycle management system
Submits electronic claims using the claims submission system in accordance with payer requirements
Resolves edits in the claim submission application
Uses provided reference material to troubleshoot edits and gain additional understanding of payer claim submission requirements
References payer websites as needed to acquire knowledge and understanding of appropriate follow up actions
Communicates and works with other team members collaboratively to understand and resolve claim edits and issues
Escalates trends and additional edits internally, to promote claim accuracy and quality applicable to Hospital Billing Revenue Cycle management system, claim submission system, and payor claims processing systems
Utilizes payer websites to identify claim submission requirements and communicate accordingly
Works specialty claims according to instruction and work with departments to resolve issues on a timely basis
Meets established productivity standards
Facilitates and promotes the sharing of knowledge and content throughout departments
Participates in cross training to optimize billing resources
Maintains and fosters an organized, clean, and safe work environment
Maintains a collaborative, team relationship with peers and colleagues in order to effectively contribute to the group’s achievement of goals and to help foster a positive work environment
Practices cost containment and fiscal responsibility through the efficient use of supplies, equipment, time, etc
Complies with established departmental policies, procedures and objectives
Attends variety of meetings, conferences, seminars as required or directed
Demonstrates use of Quality Improvement in daily operations
Complies with all health and safety regulations and requirements
Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors
Maintains, regular, reliable, and predictable attendance
Performs other similar and related duties as required or directed
Qualification
Required
High School diploma
Previous Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement
Ability to perform assigned tasks efficiently and in timely manner
Ability to work collaboratively and effectively with people
Exceptional communication and interpersonal skills
Preferred
One or more years of experience in health care billing functions
Benefits
Signing bonus
Company
UMass Memorial Health
UMass Memorial Health is the health and wellness partner of the people of Central Massachusetts.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$4.7MKey Investors
Federal Emergency Management Agency
2022-12-01Grant· $4.7M
Leadership Team
Victoria L. McCandless
Senior Vice President, Chief of Staff, System CEO Communications Officer
Sergio Melgar
EVP & CFO
Recent News
2025-11-12
Company data provided by crunchbase