Accounts Receivable Resolution Specialist

MaineGeneral Health; Waterville (ME); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Tuition reimbursement

Job summary

MaineGeneral Health is seeking a full-time Accounts Receivable Resolution Specialist to process payer claims and resolve denials to ensure timely reimbursement. The role focuses on accurate billing, verification of coverage, and coordination of benefits within a collaborative healthcare team.

The position requires 2+ years in healthcare insurance follow-up or related field, strong communication and analytical skills, and proficiency with Microsoft Office.

Qualifications

• 2 years or more work experience in Healthcare Insurance Follow Up or related field.
• Excellent communication skills.
• Analytical skills and attention to detail.
• Independent problem-solving skills.
• Strong organizational skills and ability to handle multiple tasks at once.
• Proficiency with Microsoft Office products.
• High School diploma or equivalent.

Responsibilities

• Prepares bills in paper/electronic format per payer guidelines and transmits them appropriately; ensures diagnosis and procedure codes are accurate.
• Determines and verifies insurance coverage and COB to ensure timely billing; obtains retro-authorizations as needed.
• Prepares and reviews routine billing reports, audits, worklists, and collaborates with multidisciplinary teams to ensure timely and accurate billing, re-billing, and charge corrections.
• Communicates with patients to secure accurate insurance coverage and coordination of benefits.

Skills

Excellent communication

Analytical skills

Attention to detail

Independent problem-solving

Organizational skills

Microsoft Office

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

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.

The Role

Accounts Receivable Resolution Specialist MaineGeneral Health is currently seeking a full-time Accounts Receivable Resolutions Specialist to process accurate payer claims to ensure timely reimbursement and resolves denials of payment and incorrect payments from insurance carriers.

The Opportunity

This is a fantastic opportunity to join a dynamic team of professionals; while putting your problem-solving, analytical, and attention to detail skills to work helping to ensure timely reimbursement of payments.

The Work

• Prepares bills in the paper and/or electronic format designated by departmental and payer guidelines and transmits them appropriately. Prepares, reviews, and edits claims for accuracy and submission to payers as required, ensuring proper diagnosis and procedure codes. Reviews and resolves claim rejections, denials, appeals, and issues, prepares secondary and tertiary claims as required
• Determines and verifies insurance coverage and coordination of benefits to ensure timely billing and follow-up when claims do not process and pay timely. Obtains retro-authorizations as needed and allowed
• Prepares and reviews routine billing reports, audits, worklists, and collaborates with multidisciplinary teams as necessary to ensure timely and accurate billing, re-billing, and charge corrections
• Communicates with patients as needed to secure accurate insurance coverage and coordination of benefits

You Have

• 2 years or more work experience in the Healthcare Insurance Follow Up or related field
• Excellent communication skills
• Analytical skills and attention to detail
• Independent problem-solving skills
• Strong organizational skills and ability to handle multiple tasks at once
• Proficiency with Microsoft Office products
• High School diploma or equivalent

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 [phone].