AR Specialist II

Job not on LinkedIn

October 15

🍂 Massachusetts – Remote

Although this job is listed in Massachusetts, this company may be open to hiring remote in other states.

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Accounts Receivable

🚫👨‍🎓 No degree required

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UMass Memorial Health

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Healthcare Insurance

UMass Memorial Health is a comprehensive health system located in Massachusetts. It serves as the clinical partner of UMass Chan Medical School and offers a wide range of healthcare services across its network of hospitals, including UMass Memorial Medical Center, Harrington Hospital, HealthAlliance-Clinton Hospital, Marlborough Hospital, and Milford Regional. The health system provides services in cancer care, diabetes, emergency and heart care, orthopedics, and more. It also offers behavioral health services and community health initiatives. UMass Memorial Health is renowned for its innovative clinical trials in oncology and has been recognized for its excellence in cancer programs. It serves as the exclusive healthcare provider for the Worcester Red Sox and offers extensive resources for patients, including financial counseling, price estimator tools, and various patient support services.

10,000+ employees

Founded 1884

⚕️ Healthcare Insurance

💰 $4.7M Grant on 2022-12

📋 Description

• Responsible for follow-up of complex surgical/procedural/multidisciplinary specialty claims for payments including coding and analyzing claims and claim payments/rejections. • Contacts insurance companies, while working detailed reports, to secure outstanding payments, i.e. telephone calls, websites, written appeals. • Reviews complex rejections in assigned payors and plans to determine validity of rejections and take appropriate action to resolve. • Monitors changes in reimbursement policies, including payor fee schedule reconciliation. • Performs special projects as assigned by manager or supervisor defining problems, determining work sequence and summarizing findings. • Calculates and posts adjustments based on third party reimbursement guidelines and contracts. • Makes appropriate payor and plan changes to secondary insurers or responsible parties. • Inputs missing data as required and corrects registration and other errors as indicated.

🎯 Requirements

• High School Diploma • Two years of previous Revenue Cycle knowledge including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party reimbursement. • Knowledge of multiple third-party regulations, ICD, CPT and HCPCS coding and modifier assignment. • Knowledge of billing and reimbursement practices/requirements of major third-party payors in Massachusetts. • Knowledge of medical terminology, anatomy & physiology and disease process. • Ability to organize and prioritize work to meet strict deadlines. • Computer skills to include mainframe, PC applications and excel. • Must be self-motivated, service oriented and have excellent communication skills (written and oral). • Physician coding certification is desired. • Three years of physician or medical billing experience involving complex surgical/procedural/multidisciplinary specialties preferred.

🏖️ Benefits

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