About this opportunity
UMass Chan Medical School lists this Sr. Client Operations Specialist opportunity in southborough, Massachusetts. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Sr. Client Operations SpecialistUnder the general direction of the Department Manager or designee, the Sr. Client Operations Specialist will be responsible for compiling and submitting claims for eligible health care and other services or expenditures for private, state, or federal reimbursement on behalf of contracted clients with required deadlines. The Sr. Client Operations Specialist will utilize internal systems and insurance portals to capture service and expenditure data, verify insurance eligibility, resolve rejections, and monitor denials and payments.The Sr. Client Operations Specialist will work within the Federal Claiming unit that specializes in the configuration of technical solutions and provides expertise and resources to local governmental agencies for the purposes of seeking federal reimbursement for eligible expenditures and services. Currently this unit provides medical billing or claiming solutions and support to over 250 contracted providers of school-based health, laboratory, or vaccine administration services.ResponsibilitiesCarefully review and analyze service or expenditure data provided by health care providers for discrepancies and/or missing data.Promptly validate data with providers, as appropriate.Verify insurance eligibility using insurance portals and prioritize liability by primary and secondary insurance.Review service claims held or rejected for missing data or incomplete elements.Process health care service and expenditure data required using internal systems.Analyze and monitor data, payments or denials to identify possible programmatic trends or issues.Troubleshoot issues to ensure timely processing of claims.Escalate issues appropriately, including gathering and providing detailed documentation to support and explain the issues.Serve as primary contact, representative, and subject matter expert to assigned clients.Review, maintain, update and disseminate program documents including reports, client information, manuals, and procedures.Provide ongoing outreach, education and communication to clients regarding program requirements, revenue performance and reimbursement opportunities.Collaborate with other team members to effectively and efficiently ensure customers receive timely responses.Keep abreast of any regulatory or program changes impacting requirements for reimbursement.Participate in testing of billing system upgrades or new applications, including suggesting and identifying areas for functionality improvements.QualificationsREQUIRED EDUCATION:Bachelor's Level Degree or equivalent work experienceREQUIRED WORK EXPERIENCE:3-5 years of related experience including but not limited to medical billing support, customer service, program coordination or administrationStrong proficiency with Microsoft ExcelProficiency with other essential Microsoft Office applications (Word, Outlook, Teams)Strong oral and written communication skillsDemonstrated ability to work independently to achieve objectivesWork effectively in both team and individual environmentsPREFERRED WORK EXPERIENCE:Federal claiming or medical billing experienceFamiliarity with Random Moment Time Study or other cost allocation tools.
Worksite address
southborough, MA, 01772, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.