Hospital billing claims

Are you a current UMass Memorial Health caregiver? Apply now through Workday.Monday through FridayShift:1 - Day Shift, 8 Hours (United States of America)99940 - 5418 Pre Billing and ClaimsUnion:SHARE (State Healthcare and Research Employees)This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.Everyone Is a CaregiverAt 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. Supports the timely and accurate submission of claims using provided reference material to resolve claim edits supporting timely claim submission.Prioritizes standards and guidelines to perform pre-billing and claims submission processes utilizing assigned work queues.Sorts, distributes and processes primary and secondary paper claims. Documents action taken as appropriate in the Hospital Billing revenue cycle management system.Submits electronic claims using the claims submission system in accordance with payer requirements.Resolves edits in the claim submission application.Uses provided reference material to troubleshoot edits and gain additional understanding of payer claim submission requirements.References payer websites as needed to acquire knowledge and understanding of appropriate follow up actions.Communicates and works with other team members collaboratively to understand and resolve claim edits and issues.Escalates trends and additional edits internally, to promote claim accuracy and quality applicable to Hospital Billing Revenue Cycle management system, claim submission system, and payor claims processing systems.Utilizes payer websites to identify claim submission requirements and communicate accordingly.Works specialty claims according to instruction and work with departments to resolve issues on a timely basis.Facilitates and promotes the sharing of knowledge and content throughout departments.Participates in cross training to optimize billing resources.Maintains and fosters an organized, clean, and safe work environment.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.Practices cost containment and fiscal responsibility through the efficient use of supplies, equipment, time, etc.Complies with established departmental policies, procedures and objectives.Demonstrates use of Quality Improvement in daily operations.Complies with all health and safety regulations and requirements.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.High School diplomaPrevious Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement.One or more years of experience in health care billing functions.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.Responsible managers will review competencies with position incumbents.Physical Demands and Environmental Conditions:Position requires work indoors in a normal office environment.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 will make every effort to respond to your request for disability assistance as soon as possible.

Created: 2025-09-24