Revenue Specialist

Point32Health • Canton, MA

1d • $21 - $32 • Remote

About The Position

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health . Job Summary 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
• Number of Employees: 501-1,000 employees