Clinical specialist Job at UMass Memorial Health, Worcester, MA

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  • UMass Memorial Health
  • Worcester, MA

Job Description

. Exemption Status: Non-Exempt Schedule Details: Monday through Friday Scheduled Hours: 7:30am- 4:00pm Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5426 Revenue Integrity Union: 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 Caregiver 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. Reviews standard Epic Reports (Open Encounter Report, workqueues and Revenue and Usage report) to identify and resolve charge related issues, e.g., incomplete, missed, or incorrect charges.
2. Reviews and resolves all assigned edits / respective workqueues within prescribed timeframe.
3. Collaborates with clinicians, Professional Billing Revenue Integrity Specialists and Hospital Billing CDM Specialists for proper workqueue resolution.
4. Produces and distributes standard reports to Clinic managers and Clinical leads, as assigned.
5. Collaborates with Clinical lead(s), managers and physicians for submissions to add new services or make changes to the Charge Description Master / Charge Generation Tracker.
6. Provides support to Professional Billing Revenue Integrity Specialists and Hospital Billing CDM Specialists and / or Auditors for routine audits and education sessions.
7. Performs downtime procedure process for billing area / cost center, as assigned.
8. Works independently while contributing effectively to the accomplishment of team objectives and goals. II. Position Qualifications: License/Certification/Education:

Required:
1. High School diploma required. Preferred:
1. Associate of Arts degree in the medical field (i.e., Medical Assistant, Medical Coding, etc.) Experience/Skills:

Required:
1. Demonstrated leadership ability, initiative, teamwork and assertiveness.
2. Excellent verbal, written and interpersonal communication skills.
3. Computer skills and ability to access and use multiple data systems including various PC applications, e.g. Excel, Word, Access and Power Point.
4. Analytical, research and evaluation skills required to make recommendations and implement operational improvement strategies as part of a cohesive team.
5. Ability to effectively interact with various people and adhere to team management concepts.
6. Must have the ability to maintain a positive attitude and professional manner when interacting with team members, management and other staff members. Preferred:
1. Experience working in a healthcare environment.
2. Knowledge in ICD and CPT / HCPCS coding, 3rd party payer requirements and federal and state guidelines and regulations pertaining to coding and billing practices preferred 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. 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.

Job Tags

Full time, Relocation bonus, Shift work, Day shift, Monday to Friday,

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