Public Health Reimbursement & Billing Specialist

UMass Med School; Westfield (MA); On-site; USD 58,000 - 78,000; Full time

Job summary

UMass Med School seeks a Public Provider Reimbursement Specialist to support statewide medical billing and claiming activities for MassHealth, Medicare, and related programs. The role emphasizes data entry, eligibility processing, and ensuring timely reimbursement for state-operated facilities and community programs.

You will coordinate with clients and families to determine coverage and benefits, maintain spreadsheets and databases, and provide professional service while upholding privacy

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 any data entry, to obtain from liable payers 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 (MassHealth), Medicare and commercial health care insurance, Social Security Administration and other programs and benefits.
• Outreach to, proactively support and work with clients, clients' families, guardians and representatives to complete and process applications, forms and other documents required to determine, redetermine, validate, reinstate and maintain health care coverage and related benefits.
• Perform and assist with broad spectrum of business services or specific services and focused activities.
• Review and analyze data, maintain and update spreadsheets, databases and systems and resolve discrepancies.
• Provide internal and external customers with professional customer service including responding to and following up on inquiries.
• Write, review, prepare and maintain business documents including reports, contracts, manuals, procedures and presentations.
• Participate in professional training and cross-training activities to enhance performance and skills.
• Participate in continuous quality improvement initiatives and projects.
• Foster compliance with state and federal rules and regulations.
• Work independently and as a team member and leader.
• Preserve confidential, protected health and personally identifiable information and files.
• Perform other duties and special projects as required.

Skills

Medical billing

Data entry

Microsoft Office

Education

Associate's degree

Tools

MOSAIC

Job description

UMass Med School seeks a Public Provider Reimbursement Specialist to support statewide medical billing and claiming activities for MassHealth, Medicare, and related programs. The role emphasizes data entry, eligibility processing, and ensuring timely reimbursement for state-operated facilities and community programs.

You will coordinate with clients and families to determine coverage and benefits, maintain spreadsheets and databases, and provide professional service while upholding privacy