Senior Federal Claims & Client Operations Specialist

University of Massachusetts Medical School; Westborough (MA); On-site; USD 65,000 - 90,000; Full time

Job summary

University of Massachusetts Medical School seeks a Sr. Client Operations Specialist to compile and submit claims for federal, state, or private reimbursement on behalf of contracted providers.

You will use internal systems and insurance portals to capture data, verify eligibility, resolve rejections, and monitor denials and payments. You will join the Federal Claiming unit, supporting school-based health, laboratory or vaccine administration services, and serve as the primary contact and SME for

Qualifications

• Bachelor's Degree or equivalent work experience.
• 3–5 years in medical billing support, customer service or program coordination.
• Proficient in Microsoft Excel; also Word, Outlook and Teams.
• Strong verbal and written communication skills.
• Able to work independently to meet objectives; also effective in teams.
• Preferred: federal claiming or medical billing experience; familiarity with RMTS.

Responsibilities

• Review service data for discrepancies and verify with providers.
• Validate data and check insurance eligibility via portals.
• Process claims data using internal systems.
• Monitor payments, denials, and identify trends.
• Troubleshoot issues to ensure timely processing.
• Serve as primary contact for clients and provide SME support.
• Update and disseminate program documents and procedures.
• Educate clients on program requirements and reimbursement opportunities.
• Collaborate with team to ensure timely client responses.
• Stay informed on regulatory changes affecting reimbursement.
• Participate in testing billing system upgrades.

Skills

Communication skills

Independent work

Team collaboration

Education

Bachelor's Degree or equivalent

Tools

Microsoft Excel

Microsoft Word

Outlook

Teams

Job description

University of Massachusetts Medical School seeks a Sr. Client Operations Specialist to compile and submit claims for federal, state, or private reimbursement on behalf of contracted providers.

You will use internal systems and insurance portals to capture data, verify eligibility, resolve rejections, and monitor denials and payments. You will join the Federal Claiming unit, supporting school-based health, laboratory or vaccine administration services, and serve as the primary contact and SME for