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 20000 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. Performs follow up on accounts that have not been initially adjudicated by the payer utilizing assigned work queues and prioritization standards
2. Follows up on open receivables after appeal has been submitted by Revenue Cycle departments.
3. Utilizes payor technology and resources to support account resolution activities.
4. Follows established protocols to ensure all documents are scanned in appropriately.
5. Maintains current knowledge of payer response time.
6. Responds to incoming inquiries from attorneys payers employers etc. following all hospital and regulatory guidelines.
7. Analyzes and researches accounts to determine root cause of open receivables to determine and execute the best approach for timely and accurate resolution.
8. Releases patient information following Federal State and Hospital guidelines.
9. Adjusts account balances using correct transaction code adhering to guidelines.
10. Corresponds with third party payers hospital departments and patients to obtain information required for account receivable resolution.
11. Works with team leader and/or Supervisor on account resolution strategies that optimize reimbursement. Escalates issues timely.
12. Uses established guidelines and provides support documentation needed for payer audit requests.
13. Uses reference material to troubleshoot payer issues and increase understanding of account resolution techniques.
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. Maintains and fosters an organized clean and safe work environment.
21. Contributes to the development and application of process improvements.
22. Maintains a collaborative team relationship with peers and colleagues to effectively contribute to the groups achievement of goals and to help foster a positive work environment.
23. Practices cost containment and fiscal responsibility through the efficient use of supplies equipment time etc.

Standard Staffing Level Responsibilities:

1. Complies with established departmental policies procedures and objectives.
2. Attends variety of meetings conferences seminars as required or directed.
3. Demonstrates use of Quality Improvement in daily operations.
4. Complies with all health and safety regulations and requirements.
5. Respects diverse views and approaches demonstrates Standards of Respect and contributes to creating and maintaining an environment of professionalism tolerance civility and acceptance toward all employees patients and visitors.
6. Maintains regular reliable and predictable attendance.
7. Performs other similar and related duties as required or directed.

All responsibilities are essential job functions.

II. Position Qualifications:

License/Certification/Education:
Required:
1. High School diploma

Experience/Skills:
Required:
1. 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. Ability to perform assigned tasks efficiently and in timely manner.
3. Ability to work collaboratively and effectively with people.
4. Exceptional communication and interpersonal skills.

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

Unless certification licensure or registration is required an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

III. Physical Demands and Environmental Conditions:

Work is considered sedentary. Position requires work indoors in a normal office environment.

Must have excellent attendance and work ethics.

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.

Were 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 We will make every effort to respond to your request for disability assistance as soon as possible.