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UMass Memorial Health · 1 day ago

Accounts Receivable Specialist II

Worcester, MA

Full-time

Onsite

Entry, Mid Level

$20.94/hr - $33.59/hr

2+ years exp

UMass Memorial Health is a premier health system in Central Massachusetts, dedicated to exceptional patient care and leading-edge research. They are seeking an Accounts Receivable Specialist II responsible for managing complex surgical claims, ensuring timely payments, and resolving billing issues with insurance companies.

DiabetesEducationHealth CareHospitalMedicalPersonal Health

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

Qualification

Revenue Cycle knowledgeICDCPTHCPCS codingBillingReimbursement practicesMedical terminologyComputer skillsService orientedPhysician coding certificationCommunication skillsSelf-motivatedOrganizational skills

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)

Physician coding certification is desired