Hybrid Public Reimbursement Specialist (Medicaid & Medicare)

University of Massachusetts Medical School; Westborough (MA); Hybrid; USD 55,000 - 75,000; Full time

Job summary

University of Massachusetts Medical School in Massachusetts is seeking a PPR Specialist to perform medical billing, eligibility determinations and related administrative duties within the Public Provider Reimbursement (PPR) Department of Health Care Finance Solutions (HCFS).

The role focuses on Medicare/Medicaid reimbursement for state-operated facilities and community programs, ensuring timely revenue and compliant processes while coordinating with clients, guardians and external partners.

Qualifications

• Associate's degree or equivalent experience.
• 1-3 years of related experience
• Familiarity with database and spreadsheet applications such as Microsoft Office including Word, Excel, Teams and One Drive
• Ability to communicate effectively
• Ability to adapt and change direction in response to changes in the business environment.

Responsibilities

• Perform and assist with medical billing and claiming activities, including data entry, to obtain reimbursement for services provided by state-operated facilities and community-based programs.
• Meet all claiming, eligibility and accounts receivable deadlines.
• Identify and coordinate access to Medicaid, Medicare and commercial health care insurance, Social Security Administration and other programs and benefits.
• Outreach to clients and families, guardians and representatives to complete and process applications and documents for benefits.
• Review data, maintain spreadsheets and resolve discrepancies.
• Provide professional customer service to internal and external customers.

Skills

Effective communication

Adaptability

Education

Associate's degree or equivalent experience

Tools

Microsoft Office (Word, Excel, Teams, OneDrive)

Job description

University of Massachusetts Medical School in Massachusetts is seeking a PPR Specialist to perform medical billing, eligibility determinations and related administrative duties within the Public Provider Reimbursement (PPR) Department of Health Care Finance Solutions (HCFS).

The role focuses on Medicare/Medicaid reimbursement for state-operated facilities and community programs, ensuring timely revenue and compliant processes while coordinating with clients, guardians and external partners.