Public Provider Reimbursement Specialist (2026-51941)

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When you join the UMass Chan Medical School team, you join us in advancing together to improve the health and well-being of our diverse communities throughout Massachusetts and across the US and the world. Together, we lead in education, research, health care delivery, and public service. Your life's work is more than a career. It's an expression of your passion, intellect, skill, and drive. UMass Chan"s commitment to excellence, innovation, competitive benefits, and work-life integration will allow you to build a professionally rewarding career as we work together to better or improve the health of people around the globe.

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Public Provider Reimbursement Specialist

Job Number: 2026-51941

Category: Administrative Support

Location: Westborough, MA

Shift: Day

Exempt/Non-Exempt: Non Exempt

Business Unit: UMass Chan Medical School

Department: PPR

Job Type: Full-Time

Union Code: Union Position - NAGE Admin and Professional (W50)

Num. Openings: 1

Post Date: Sept. 4, 2026

Work Location: Hybrid

Salary Minimum: USD $50,024.00/Yr.

Salary Maximum: USD $63,897.60/Yr.

POSITION SUMMARY:

The Public Provider Reimbursement (PPR) Department withinHealth Care Finance Solutions (HCFS) unit conducts statewide business services for several health and human services agencies of the Executive Office of Health and Human Services (EOHHS) to maximize revenue for the Commonwealth of Massachusetts. Revenue is obtained from private, state and federal resources to reimburse the Commonwealth for the costs of health care and related services provided by public institutions and community-based programs. The PPR Specialist is responsible for performing medical billing and claiming functions, activities to identify and coordinate access to health care insurance and related benefits, and administrative and clerical duties.

ESSENTIAL FUNCTIONS:

• Perform and assist with medical billing and claiming activities, including any data entry, to obtain from liable payers reimbursement for services provided by state-operated facilities and community-based programs.
• Meet all claiming, eligibility and accounts receivable deadlines.
• Identify and coordinate access to Medicaid (MassHealth), Medicare and commercial health care insurance, Social Security Administration and other programs and benefits.
• Outreach to, proactively support and work with clients, clients families, guardians and representatives to complete and process applications, forms and other documents required to determine, redetermine, validate, reinstate and maintain health care coverage and related benefits.
• Perform and assist with broad spectrum of business services or specific services and focused activities.
• Review and analyze data, maintain and update spreadsheets, databases and systems and resolve discrepancies.
• Provide internal and external customers with professional customer service including responding to and following up on inquiries.
• 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.
• Participate in continuous quality improvement initiatives and projects.

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.
• Perform other duties and special projects as required.

Required Qualifications:

• Associates 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 One Drive
• Ability to communicate effectively
• Ability to adapt and change direction in response to changes in the business environment.

Preferred Qualifications:

• Medical billing or health care insurance experience
• Basic Knowledge of accounting
• Knowledge of state and federal rules and regulations related to health care finance
• Knowledge of state and federal information systems such as HUB, MA21, MMIS and Mosaic

The PPR Specialist is responsible for performing Charges for Care and Benefit Eligibility functions for the Department of Developmental Services (DDS), Southeast Region. This role supports individuals residing in State-Operated Homes by ensuring the accurate administration of room and board billing, reimbursement, and benefit eligibility processes. The PPR Specialist works collaboratively with internal and external stakeholders to maintain compliance, promote timely revenue collection, and ensure clients receive appropriate benefits and services.

This position is based at the Wrentham Developmental Center on Emerald Street in Wrentham and follows a hybrid work schedule that combines in-office and remote work. Minimal travel may be required to attend meetings and other work-related activities.

Posting Disclaimer:

This job posting outlines the primary responsibilities and qualifications for the role but is not intended to be an exhaustive list. Duties and expectations may evolve in response to the needs of the department and the broader institution.

In alignment with our commitment to pay transparency, the base salary range for this position is listed above (exclusive of benefits and retirement). At UMass Chan Medical School, final base salary offers are determined based on a combination of factors, including your skills, education, and relevant experience. We also consider internal equity to ensure fair and consistent compensation across our teams.

Please note that the range provided reflects the full base salary range for this position. Offers are typically made within the midrange to allow for future growth and development within the role.

In addition to base pay, UMass Chan offers a comprehensive Total Rewards package, which includes paid time off, medical, dental, and vision coverage, and participation in a 401(a)-retirement plan, with the option to contribute to a voluntary 403(b) plan.

UMass Chan welcomes all qualified applicants and complies with all state and federal anti-discrimination laws.

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Email: HRTalentAcquisition@umassmed.edu

Phone: 508-856-5260