Revenue Operations Coordinator

2 weeks ago

Westfield Massachusetts, United States University of Massachusetts Medical School Full time

Overview:

POSITION SUMMARY:


The Revenue Operations Department within the Health Care Finance Solutions (HCFS) unit is dedicated to delivering comprehensive business services for various health and human services agencies. Our mission is to optimize revenue streams for the Commonwealth of Massachusetts.

We focus on securing funds from private, state, and federal sources to reimburse the Commonwealth for the expenses incurred in providing health care and associated services through public institutions and community-based programs.

The Revenue Operations Coordinator is tasked with executing medical billing and claims processing functions, facilitating access to health care insurance and related benefits, as well as performing administrative and clerical responsibilities.


Responsibilities:

ESSENTIAL FUNCTIONS:


Assist with medical billing and claims processing activities, including data entry, to secure reimbursement from responsible payers for services rendered by state-operated facilities and community-based programs.

Ensure compliance with all claiming, eligibility, and accounts receivable deadlines.


Identify and facilitate access to Medicaid (MassHealth), Medicare, and commercial health care insurance, as well as Social Security Administration and other relevant programs and benefits.


Engage with clients, their families, guardians, and representatives to assist in completing and processing applications, forms, and other necessary documentation to determine, re-evaluate, validate, reinstate, and maintain health care coverage and associated benefits.

Perform a wide range of business services or specific tasks and focused activities.


Review and analyze data, maintain and update spreadsheets, databases, and systems, and resolve any discrepancies.


Deliver professional customer service to both internal and external clients, including responding to and following up on inquiries.


Draft, review, prepare, and maintain business documents such as reports, contracts, manuals, procedures, and presentations.


Participate in professional development and cross-training initiatives to enhance skills and performance.


Engage in continuous quality improvement projects and initiatives.


Ensure adherence to state and federal regulations and guidelines.


Work independently as well as collaboratively as a team member and leader.


Safeguard confidential, protected health information and personally identifiable information.


Perform additional duties and special projects as assigned.




Qualifications:
Required

Qualifications:
Associate's degree or equivalent experience.

1-3 years of relevant experience

Proficiency in database and spreadsheet applications such as Microsoft Office, including Word, Excel, Teams, and One Drive.

Strong communication skills.

Ability to adapt and respond to changes in the business environment.

Preferred

Qualifications:
Experience in medical billing or health care insurance.

Understanding of state and federal regulations related to health care finance.

Familiarity with state and federal information systems.
Additional Information:


The Revenue Operations Department generates significant gross charges to liable payers and contributes substantial net revenue to the Commonwealth.

We provide various business services statewide for multiple health and human services agencies and numerous public facilities, including hospitals, mental health centers, clinics, and community-based services.

The Revenue Operations Coordinator will collaborate closely with departmental staff and engage with personnel from various health and human services agencies.


This position offers a hybrid work model with minimal travel required for meetings.

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