Accounts Receivable Specialist I, Physican Billing.

UMass Memorial Health - Worcester, MA

Full-time - Entry Level

Worcester, MA

10,001+ employees

Ambulatory Health Care Services

About the position

The Accounts Receivable Specialist I in Physician Billing at UMass Memorial Health Care plays a crucial role in the revenue cycle management process. This position is responsible for the follow-up of complex claims for payment, ensuring that outstanding payments are secured efficiently. The specialist will engage in direct communication with insurance companies, utilizing both phone calls and payor websites to work through detailed reports that highlight outstanding payments. This role requires a thorough review of rejections from assigned payors to determine their validity, followed by appropriate actions to resolve any invoicing issues. The specialist will also be tasked with calculating and posting adjustments based on third-party reimbursement guidelines and contracts, ensuring that all financial transactions are accurately recorded. In addition to these responsibilities, the Accounts Receivable Specialist I will make necessary changes to secondary insurers or responsible parties as required. This includes inputting missing data and correcting registration errors to maintain accurate records. The position operates within a structured schedule, typically Monday through Friday, with various shift options available to accommodate the needs of the department. UMass Memorial Health emphasizes a culture where every employee is considered a caregiver, contributing to exceptional patient care and a collaborative work environment. The organization is committed to diversity and inclusion, encouraging applicants from varied backgrounds to apply and join their mission of healing and respect.

Responsibilities

• Follow up on complex claims for payment.
• Call insurance companies and utilize payor websites to secure outstanding payments.
• Review rejections from assigned payors to determine validity and take appropriate action to resolve invoices.
• Calculate and post adjustments based on third-party reimbursement guidelines and contracts.
• Make necessary changes to secondary insurers or responsible parties as required.
• Input missing data and correct registration and other errors as indicated.

Requirements

• High school diploma or GED required.
• Previous Revenue Cycle knowledge in areas such as PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding, or 3rd party Reimbursement.
• Ability to perform assigned tasks efficiently and in a timely manner.
• Ability to work collaboratively and effectively with people.
• Exceptional communication and interpersonal skills.

Nice-to-haves

• One or more years of experience in health care billing functions.

Benefits

• Potential signing bonus available.
• Full-time employment with a structured schedule.
• Opportunities for career growth within a large health system.