Sr. Client Operations Specialist (2026-52065)

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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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Sr. Client Operations Specialist

Job Number: 2026-52065

Category: Administrative Professional

Location: Westborough, MA

Shift: Day

Exempt/Non-Exempt: Exempt

Business Unit: UMass Chan Medical School

Department: School Based Claiming-In State

Job Type: Full-Time

Union Code: Non Union Position - Non Unit Professional (W60)

Num. Openings: 1

Post Date: Sept. 17, 2026

Work Location: 100% Remote

Salary Minimum: USD $48,000.00

Salary Maximum: USD $58,000.00

Under the general direction of the Department Manager or designee, the Sr. Client Operations Specialist will be responsible for compiling and submitting claims for eligible health care and other services or expenditures for private, state, or federal reimbursement on behalf of contracted clients with required deadlines. The Sr. Client Operations Specialist will utilize internal systems and insurance portals to capture service and expenditure data, verify insurance eligibility, resolve rejections, and monitor denials and payments.

The Sr. Client Operations Specialist will work within the Federal Claiming unit that specializes in the configuration of technical solutions and provides expertise and resources to local governmental agencies for the purposes of seeking federal reimbursement for eligible expenditures and services. Currently this unit provides medical billing or claiming solutions and support to over 250 contracted providers of school-based health, laboratory, or vaccine administration services.

• Carefully review and analyze service or expenditure data provided by health care providers for discrepancies and/or missing data.
• Promptly validate data with providers, as appropriate.
• Verify insurance eligibility using insurance portals and prioritize liability by primary and secondary insurance.
• Review service claims held or rejected for missing data or incomplete elements.
• Process health care service and expenditure data required using internal systems.
• Analyze and monitor data, payments or denials to identify possible programmatic trends or issues.
• Troubleshoot issues to ensure timely processing of claims.
• Escalate issues appropriately, including gathering and providing detailed documentation to support and explain the issues.
• Serve as primary contact, representative, and subject matter expert to assigned clients.
• Review, maintain, update and disseminate program documents including reports, client information, manuals, and procedures.
• Provide ongoing outreach, education and communication to clients regarding program requirements, revenue performance and reimbursement opportunities.
• Collaborate with other team members to effectively and efficiently ensure customers receive timely responses.
• Keep abreast of any regulatory or program changes impacting requirements for reimbursement.
• Participate in testing of billing system upgrades or new applications, including suggesting and identifying areas for functionality improvements.

REQUIRED EDUCATION:

Bachelor"s Level Degree or equivalent work experience

REQUIRED WORK EXPERIENCE:

• 3-5 years of related experience including but not limited to medical billing support, customer service, program coordination or administration
• Strong proficiency with Microsoft Excel
• Proficiency with other essential Microsoft Office applications (Word, Outlook, Teams)
• Strong oral and written communication skills
• Demonstrated ability to work independently to achieve objectives
• Work effectively in both team and individual environments

PREFERRED WORK EXPERIENCE:

• Federal claiming or medical billing experience
• Familiarity with Random Moment Time Study or other cost allocation tools.

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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