Schedule Details:

Scheduled Hours:

Shift:

Hours:

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

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 16,000 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. Secures payments before the patient arrives, or leaves the patient care area. Prepares form letters to patients for cost share information and collection.
2. Must be able to assist patient in filling out state applications, or other assistance applications for available programs that may assist patients in meeting their financial obligations, such as Uninsured Relief, Copay Relief, Self Pay Mammo Program, HSNO Uninsured ER Free Care, etc. Provide additional follow-up and/or assistance in order to arrive to resolution on Assistance Applications (ex. MassHealth, HIX, Uninsured Relief, Copay Relief, payment plans/options, etc.)
3. Acts as customer service representative for complaints and walk in patients. Documents the complaints & forwards complaints to Quality, Med Records, Billing or Credit Manager as appropriate.
4. Assess self-pay accounts and processes, as necessary, per determined required collection activity, including early out self-pay outsource, bad debt turnover for delinquent accounts, returned accounts for reporting to Medicare pool, HSNO uninsured ER accounts for state submission, etc., in accordance with our credit and collection policy.
5. Verifies eligibility, submits HSNO claims to state and further reviews related MMIS and HSNO denials.
6. Investigates and processes adjustments, billing and balance inquiry requests from agencies.
7. Responds to billing inquiries, denials, and other in-person/correspondence/telephone requests in an efficient and effective manner and ensuring detailed documentation of such in a patient's account(s).
8. Performs insurance eligibility verification for appropriate inpatient, observation, and other patient account as appropriate in collaboration with Admitting and Utilization Review.
9. Acts as clerical support as needed for the department.
10. Performs other duties as assigned or directed to ensure smooth operation of the department/unit.
11. Facilitates in gathering accurate patient billing information.
12. Performs collections of patients with outstanding accounts receivable. Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc. via obtaining accurate demographic and financial information).
13. Receives and processes patient payments. Maintains necessary petty cash to properly service and receive payments.
14. Answers patient inquiries regarding their liability and able to explain the variables involved.
15. Properly receipting and forwarding all copies of patient payment receipts posting to the patient's account in appropriate system.
16. Perform end of day duties closing and reconciliation duties in appropriate system and reconcile deposit slips.

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. Must be able to obtain state Certified Application Counselor designation within 3 months of hire.

Preferred:
1. Minimum High School Diploma, or G.E.D., business concentration

Experience/Skills:
Required:
1. Five plus (5+) years of experience required in revenue cycle (billing, collecting, front office) of a medical facility or collection agency
2. Prior experience in a healthcare environment
3. Must demonstrate strong Excel skills and be able to analyze self-pay A/R receivables and trend bad debt recoveries
4. Knowledge of third party collections and reimbursement, preferably with governmental agencies.
5. Experience with automated systems and computers
6. Ability to interpret A/R reports and to prioritize work flow and activity around available information.
7. Strong customer services skills.

Preferred:
1. Billing experience
2. Medical terminology experience and bi-lingual (English/Spanish)

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:

On-the-job time is spent in the following physical activities:
1. Stand - 1/3
2. Walk - 1/3
3. Sit - 2/3
4. Talk or hear - 2/3
5. Uses hands to finger, handle or feel - 2/3

This job requires that weight be lifted or force be exerted:
1. Up to 10 pounds - 1/3

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.