Revenue Operations Specialist - Public Health Billing

UMass Chan Medical School; Taunton (MA); On-site; USD 55,000 - 75,000; Full time

Job summary

The University of Massachusetts Chan Medical School seeks a PPR Specialist to perform medical billing, eligibility checks, and benefits coordination for MassHealth, Medicare, and related programs. You will support a statewide revenue-maximization effort with strong attention to data accuracy and confidentiality.

Ideal candidates hold an associates degree or equivalent, 1–3 years of related experience, and proficiency with MS Office.

Qualifications

• Associates 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

Effective communication

Adaptability

Education

Associates degree or equivalent experience

Tools

Microsoft Word

Microsoft Excel

Microsoft Teams

OneDrive

Job description

The University of Massachusetts Chan Medical School seeks a PPR Specialist to perform medical billing, eligibility checks, and benefits coordination for MassHealth, Medicare, and related programs. You will support a statewide revenue-maximization effort with strong attention to data accuracy and confidentiality.

Ideal candidates hold an associates degree or equivalent, 1–3 years of related experience, and proficiency with MS Office.