Revenue Specialist

Point32Health • Canton, MA

3d • $21 - $32 • Hybrid

About The Position

The Revenue Specialist develops and refines member eligibility and payment records. This role ensures the accuracy of the beneficiary files and data submission. The incumbent learns and understands department process interdependencies, contributes to process enhancement opportunities, and supports departmental objectives

Requirements

• Associate degree
• 1-2 years related business experience
• Significant MS Office skills, with focus on Excel and Access at intermediate/advanced level.
• Solid communication skills (effective verbal and written skills).
• Strong organizational and time management skills.
• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

Nice To Haves

• Some undergraduate college courses preferred.
• Financial background a plus

Responsibilities

• Expands knowledge of the monthly payments received by CMS
• Updates daily/monthly records received from CMS in all systems accordingly to match each other and to match CMS.
• Reviews/researches data rejects
• Adjusts member records and set sequences in Market Prominence (MP), Diamond, and HealthRules Payor (HRP) – Special Status Beneficiaries
• Works MSP (Medicare Secondary Payor) records, ensuring letters are sent to members timely, that incoming mail is completed quickly while updating in CMS system the responses from members.
• Work with Claims department to ensure updates affecting a member’s claims are completed timely and accurately.
• Other duties as assigned

Benefits

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree