PPR Specialist

Job Summary:

The PPR Specialist will play a crucial role in the Public Provider Reimbursement (PPR) Department at UMass Med School, conducting statewide business services for health and human services agencies to maximize revenue for the Commonwealth of Massachusetts.

Key Responsibilities:

• Perform medical billing and claiming activities, including data entry, to obtain reimbursement from liable payers for services provided by state-operated facilities and community-based programs.
• Meet claiming, eligibility, and accounts receivable deadlines.
• Identify and coordinate access to Medicaid, Medicare, and commercial health care insurance, Social Security Administration, and other programs and benefits.
• Provide professional customer service, responding to and following up on inquiries from internal and external customers.
• Write, review, prepare, and maintain business documents, including reports, contracts, manuals, procedures, and presentations.
• Participate in professional training and cross-training activities to enhance performance and skills.
• Foster compliance with state and federal rules and regulations.
• Work independently and as a team member and leader.
• Preserve confidential, protected health, and personally identifiable information and files.

Requirements:

• Associate's degree or equivalent experience.
• 1-3 years of related experience.
• Familiarity with database and spreadsheet applications, such as Microsoft Office, including Word, Excel, Teams, and OneDrive.
• Ability to communicate effectively.
• Ability to adapt and change direction in response to changes in the business environment.