Medicaid Billing & Reimbursement Specialist

UMass Med School; Taunton (MA); On-site; USD 50,000 - 60,000; Full time

Job summary

UMass Med School in Taunton, MA is seeking a PPR Specialist to perform medical billing and claiming, identify health coverage options, and support administrative duties within the HCFS unit. You will collaborate with state programs and health agencies to maximize revenue for Massachusetts public institutions.

The role emphasizes reviewing data, maintaining systems, and delivering high-quality customer service while complying with regulations. Strong communication and adaptability are essential.

Qualifications

• Associate's degree or equivalent experience.
• 1-3 years of related experience.
• Familiar with Microsoft Office including Word, Excel, Teams and OneDrive.
• Ability to communicate effectively.
• Ability to adapt and change direction in response to changes in the business environment.

Responsibilities

• Perform medical billing and claiming activities to obtain reimbursement from liable payers.
• Meet all claiming, eligibility and accounts receivable deadlines.
• Identify and coordinate access to MassHealth, Medicare and other programs and benefits.
• Outreach to clients and families to complete applications and documents needed for health care coverage.
• Review data, maintain spreadsheets and resolve discrepancies.
• Provide professional customer service to internal and external customers.
• Write, review, prepare and maintain business documents and reports.
• Participate in training and cross-training activities to enhance performance.
• Engage in continuous quality improvement and ensure compliance with state/federal rules.
• Work independently and as a team member and leader.
• Preserve confidential information and protect PHI/PII.
• Perform other duties as required.

Skills

Communication

Adaptability

Teamwork

Education

Associatedegree or equivalent experience

Tools

Microsoft Office

Word

Excel

Teams

OneDrive

Job description

UMass Med School in Taunton, MA is seeking a PPR Specialist to perform medical billing and claiming, identify health coverage options, and support administrative duties within the HCFS unit. You will collaborate with state programs and health agencies to maximize revenue for Massachusetts public institutions.

The role emphasizes reviewing data, maintaining systems, and delivering high-quality customer service while complying with regulations. Strong communication and adaptability are essential.