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Exemption Status:

Hiring Range:

Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule Details:

Scheduled Hours:

Shift:

Hours:

Cost Center:

Union:

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Major Responsibilities:

1. Using assigned work queues and prioritization standards, performs follow up on accounts that have not been initially adjudicated by the payer. Work queues assigned will be representative of complex analysis, escalation, and rapid resolution.
2. Performs follow up on open receivables after appeal has been submitted by Denial Specialist and Payment variance specialist.
3. Maintains current knowledge of payer response time.
4. Responds to incoming inquiries from attorneys, payers, employers etc following all hospital and regulatory guidelines.
5. Analyzes and researches accounts to determine root cause of open receivables to determine and execute the best approach for timely and accurate resolution.
6. Releases patient information following Federal, State and Hospital guidelines.  
7. Corresponds with third party payers, hospital departments, and patients to obtain information required for account receivable resolution.
8. Adjusts account balances using correct transaction code while adhering to guidelines.  
9. Interacts with payer provider relations staff to escalate and resolve accounts receivable follow up issues.
10. Works with team lead and/or Supervisor on account resolution strategies that optimize reimbursement. Escalates issues timely.
11. Uses established guidelines and support documentation needed for payer audit requests.  
12. Uses reference material to troubleshoot payer issues and increase understanding of account resolution techniques.
13. Trains staff on payer websites providing basic guidance and instruction on website navigation.
14. References payer websites as needed to acquire knowledge and understanding of appropriate follow up actions.
15. Meets established productivity standards.
16. Facilitates and promotes the sharing of knowledge and content throughout departments.
17. Follows all established Hospital Billing revenue cycle management departmental and compliance policies and procedures.
18. Adheres to change control processes.
19. Participates in cross training to optimize department resources.
20. Demonstrates excellent attendance and actively participates in a variety of meetings and training sessions as required.
21. Complies with established environment of care/safety policies and procedures and all health and safety requirements.
22. Maintains and fosters an organized, clean and safe work environment.
23. Actively contributes to the development and application of process improvements.
24. Maintains a collaborative, team relationship with peers and colleagues in order to effectively contribute to the group’s achievement of goals and to help foster a positive work environment.
25. Demonstrates respect for the diversity of patient and employee populations. Supports and encourages diverse points of view, work, and lifestyles.
26. Practices cost containment and fiscal responsibility through the efficient use of supplies, equipment, time, etc.
27. Performs a variety of related duties as assigned by management.
28. Performs assigned tasks efficiently and in timely manner.

II. Position Qualifications:

License/Certification/Education:
Required:
1. A minimum of a High School diploma.

Experience/Skills:
Required:
1. Two or more years of previous Revenue Cycle knowledge including experience in one of the following areas PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding or 3rd party Reimbursement. 
2. Knowledge of multiple third-party regulations
3. Goal oriented with high standards for quality and performance.
4. Ability to work collaboratively and effectively with people. 
5. Exceptional communication and interpersonal skills.

Preferred:
1. Two or more years of experience in health care billing functions.
2. Experience in accounts receivable follow-up process. 

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.