Job Information
MaineGeneral Health Accounts Receivable Resolution Specialist in Waterville, Maine
Job Summary:MaineGeneral Health. We’re with you. Be with us!
MaineGeneral Health is a comprehensive non-profit system with the mission of enhancing, every day, the health of our patients, our families and our communities.
If you are looking for the opportunity to support your friends, family, and your community through your work at MaineGeneral Health...Come be with us.
Job Description:
Join Our Team as an Accounts Receivable Resolution Specialist
The Opportunity:
This role presents an exciting opportunity to become an integral part of our dynamic team of professionals. You'll harness your problem-solving, analytical, and attention-to-detail skills to ensure payments are reimbursed promptly and accurately.
Key Responsibilities:
Billing Preparation: Prepare bills in both paper and electronic formats as per departmental and payer guidelines. Review and edit claims for accuracy before submission to payers, ensuring the correct diagnosis and procedure codes are used.
Claim Resolution: Review and address claim rejections, denials, and appeals, taking necessary actions to rectify issues. Prepare secondary and tertiary claims when required.
Insurance Verification: Determine and verify insurance coverage and coordination of benefits to facilitate timely billing. Obtain retro-authorizations as necessary and allowed by policies.
Billing Management: Prepare and review routine billing reports, audits, and worklists. Collaborate with multidisciplinary teams as needed to ensure billing accuracy, re-billing, and charge corrections.
Patient Communication: Communicate with patients as needed to obtain accurate insurance coverage and coordinate benefits.
Qualifications:
Relevant Experience: A minimum of 2 years of work experience in Healthcare Insurance Follow-Up, Medical Billing, or a related field is required.
Knowledge of Medical Billing Procedures: Familiarity with medical billing processes, including claim submission, coding, and insurance verification, is essential.
Attention to Detail: Strong attention to detail is crucial for accurately reviewing and editing claims, ensuring compliance with payer guidelines and regulations.
Problem-Solving Skills: Ability to identify issues with claims and payment discrepancies and take proactive measures to resolve them effectively.
Communication Skills: Excellent communication skills are essential for effectively liaising with patients, insurance carriers, and internal teams to ensure seamless billing processes.
Scheduled Weekly Hours: 40
Scheduled Work Shift:
Job Exempt: No
Benefits:
Supporting all aspects of our employees’ wellness – physical, emotional and financial – is a critical component of being a great place to work. With the wide range of benefits and programs available, employees have the resources they need to be well at every stage of life and plan for the future.
Physical Wellness:
We offer quality health, dental, and vision benefits and wellness programs and resources to provide employees access to resources for a healthy lifestyle and help manage health care costs.
Employees have access to industry-leading leave for new parents.
A generous earned time plan is offered to all employees - We believe employees need and deserve time away from work to observe holidays, be with family, go on vacation, or simply take care of themselves.
Emotional Wellness:
When life gets challenging, employees have access to our Employee Assistance Program for employees and anyone in their household.
Financial Wellness:
An employee discount program is available to all employees for services provided by MaineGeneral Medical Center.
Tuition Reimbursement is available to all employees to further develop skills and career.
We offer eligible employees up to 2% of eligible pay in 403(b) company-matching contributions plus another 2% in the 401(a) retirement income plan.
Three insurance plans are available to protect your family from the sudden loss of income in the event of your death, terminal illness or serious injury from accident.
We offer both short-term and long-term disability insurance to replace a portion of your income if you become disabled and cannot work for a period of time.
Career Mobility:
Helping our employees develop their skills and grow their careers is critical to how we retain our talent and sustain our business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know that our employees are our most valuable resource – they’re how we grow our business and care for our community.
Equal Opportunity Employer M/F/Vet/Disability Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 .
Equal Opportunity Employer M/F/Vet/Disability: In furtherance of MaineGeneral's policy regarding Equal Employment Opportunity, MaineGeneral has developed a written Affirmative Action Program which sets forth the policies, practices and procedures that MaineGeneral is committed to in order to ensure that its policy of nondiscrimination and affirmative action is accomplished.
The Affirmative Action Plan for Veterans and Individuals with Disabilities is available for inspection by any employee or candidate for employment upon request, during normal business hours, in the Human Resources Department. Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 . EEO is Law (https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf)