Accounts Receivable Specialist II at UMass Memorial Health – Worcester, Massachusetts

Position Title: Accounts Receivable Specialist II

Location: Worcester, MA Worcester Business Center

Time Type: Full time

Remote Type: Remote Caregivers (Primarily Remote)

Job Category: Finance

Job Family: Revenue Cycle

Job Type: Regular

Req ID: R25113371-1

Description:

Are you a current UMass Memorial Health caregiver? Apply now through Workday.

Exemption Status:
Non-Exempt

Hiring Range:
$20.94 - $33.59
Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule Details:
Monday through Friday

Scheduled Hours:
6 to 2:30pm 6:to 3pm 7 to 3:30pm 8 to 4:30pm

Shift:
1 - Day Shift, 8 Hours (United States of America)

Hours:
40

Cost Center:
99940 - 5454 Surgery 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.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

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

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

Major 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.
• Hours vary: 6 to 2:30pm, 6:to 3pm, 7 to 3:30pm, or 8 to 4:30pm

Position Qualifications:

License/Certification/Education:

Required:

• High School Diploma

Experience/Skills:

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.
• 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.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.

About Us:

At UMass Memorial Health, everyone is a caregiver. No matter their responsibilities or title, every employee or "caregiver" fills an important role for our patients and their families every day. Who is a caregiver? It's not just the person who delivers the care. It's all the people who make it work ... and make it better. Caregivers give everything that helps patients heal, from expertise to extra attention. They give clean, comfortable rooms. Fast, accurate answers. And an easier, less stressful experience. They give warm, reassuring smiles, and helping hands. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, our community and each other. And everyone, in their own unique way, plays an important part, every day.