Public Provider Revenue & Billing Specialist

University of Massachusetts Medical School; Montgomery (MA); On-site; USD 45,000 - 65,000; Full time

Job summary

University of Massachusetts Medical School is seeking a PPR Specialist within the Public Provider Reimbursement (PPR) Department of Health Care Finance Solutions (HCFS) to perform medical billing, eligibility work, and benefits coordination for statewide programs.

Responsibilities include meeting deadlines, coordinating access to MassHealth and other programs, and maintaining data while delivering professional customer service to internal and external stakeholders.

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 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 clients, clients’ families, guardians and representatives to complete and process applications and documents required to determine, redetermine, validate, reinstate and maintain health care coverage and related benefits.
• Review data, maintain 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.

Skills

Effective communication

Adaptability

Microsoft Office

Education

Associate’s degree or equivalent experience

Job description

University of Massachusetts Medical School is seeking a PPR Specialist within the Public Provider Reimbursement (PPR) Department of Health Care Finance Solutions (HCFS) to perform medical billing, eligibility work, and benefits coordination for statewide programs.

Responsibilities include meeting deadlines, coordinating access to MassHealth and other programs, and maintaining data while delivering professional customer service to internal and external stakeholders.