Requisition #: 194111
Title: Medical Biller Accounts Receivable Specialist I
Department: Professional Billing Central Billing Office (PBCBO)
Grade: ADM5
Posting Date: July 17, 2019
Status: Non-Exempt
Shift: Days
Union: SHARE
Hours: 40
Shift Length: 8 hours
Location: UMass Memorial Health Care – 306 Belmont St, Worcester, MA
$1000 SIGN-ON OR REFERRAL BONUS
Monday-Friday 40 hours
OT as needed
UMass Memorial Health Care is the largest health care system in Central Massachusetts. We are the clinical partner of UMass Medical School, with access to the latest technology, research and clinical trials. Our health care system includes four hospitals:
In addition to our fully equipped medical centers, our system also includes home health and hospice programs, behavioral health programs and community-based physician practices.
Position Summary:
Responsible for follow-up of complex claims for payment.
Position Qualifications:
High School Diploma required. Three years of physician or medical billing experience required. Knowledge of regulations multiple major third party insurance carriers. Knowledge of billing and reimbursement requirements of Third Party Payors in the State of Massachusetts including ICD, CPT and HCPCS coding, modifier assignment as well as medical terminology. 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).
Major Responsibilities:
Calls insurance companies and utilizes payor web-sites while working detailed reports to secure outstanding payments.
Reviews rejections in assigned payors and plans to determine validity of rejection and takes appropriate action to resolve the invoice.
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.
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 established departmental policies, procedures, and objectives.
Respects diverse views and approaches, and contributes in maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
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, and contributes in maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
Performs other similar and related duties as required or directed.
All responsibilities are essential job functions.