Clinical Data Coordinator

Department of Health and Human Services; Water Street (PA); Hybrid; USD 50,788,000 - 69,478,000; Full time

Benefits offered by this job

Paid holidays

Vacation leave

Health insurance

Dental insurance

Retirement plan

Gym membership reimbursement

Flexible spending accounts

Student loan forgiveness

Parental leave

Deferred compensation

Job summary

Department of Health and Human Services in Augusta, ME seeks a Medical Care Coordinator to manage clinical records, validate information, and analyze claims to support program operations.

The role involves processing medical claims, communicating with patient navigators about abnormal results, and ensuring data reporting compliance while maintaining confidentiality.

Qualifications

• Four-year combination of education and experience in medical eligibility programs and/or experience which demonstrates interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions, and payment authorization.

Responsibilities

• Manage and maintain accurate clinical records, ensuring timely collection and entry of screening and diagnostic data
• Review and validate clinical information to ensure compliance with program guidelines and coverage criteria
• Analyze claims and clinical data reports to support program operations
• Process medical claims and resolve billing issues for clients, providers, and internal staff
• Partner with patient navigators to communicate abnormal screening results, supporting timely follow-up care
• Monitor provider compliance with data reporting
• Serve as a subject matter resource for providers by delivering guidance on MBCHP billing processes
• Use independent judgment to prioritize tasks, solve problems, and ensure high-quality, accurate work

Skills

Records management

Data entry

Claims analysis

Billing support

Patient communication

Data reporting

Provider guidance

Prioritization

Job description

Department of Health and Human Services (DHHS) Medical Care Coordinator Opening Date: September 9, 2026 Closing Date: September 22, 2026 Job Class Code: 5055 Grade: 16 (04) Salary: $17.69 - $24.27 per hour Position Number: 02000-2404 Location: Augusta This position allows for partial telework with management approval. Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

Core Responsibilities

• Manage and maintain accurate clinical records, ensuring timely collection and entry of screening and diagnostic data
• Review and validate clinical information to ensure compliance with program guidelines and coverage criteria
• Analyze claims and clinical data reports to support program operations
• Process medical claims and resolve billing issues for clients, providers, and internal staff
• Partner with patient navigators to communicate abnormal screening results, supporting timely follow-up care
• Monitor provider compliance with data reporting
• Serve as a subject matter resource for providers by delivering guidance on MBCHP billing processes
• Use independent judgment to prioritize tasks, solve problems, and ensure high-quality, accurate work

Minimum Qualifications

A four (4) year combination of education and experience in medical eligibility programs and/or experience which demonstrates interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions, and payment authorization.

Preferred Candidates

• A collaborative, team-oriented mindset with a commitment to customer service
• Experience working with patients, clinical, or health-related data systems preferred
• Ability to handle sensitive and confidential information with professionalism and discretion
• Comfort working in a role connected to cancer care and women's health

Agency Information

The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience, and opportunity for Maine people. The Department provides health and social services to approximately a third of the State's population, including children, families, older Mainers, and individuals with disabilities, mental illness, and substance use disorders. The Department also promotes public health, operates two state psychiatric hospitals, and provides oversight to health care providers. The mission for the Maine Center for Disease Control and Prevention (Maine CDC), within which this position is located, is to develop and deliver services to preserve, protect, and promote the health and well-being of the citizens of Maine.

Application Information

For questions about this position, please contact Kawther Mohamed at [e-mail]. Please submit all documents or files in PDF or Word format. To request a paper application, please contact [e-mail].

Benefits of working for the State of Maine

• Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave. When you or immediate members of your family are ill, utilize 12 days of sick leave per year.
• Health Insurance Coverage – The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 - $13,650.48 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.
• Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements.
• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($365.28 annual value).
• Retirement Plan – The State contributes the equivalent of 14.06% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.
• Gym Membership Reimbursement – Improve overall health with regular exercise and receive up to $40 per month to offset this expense.
• Health and Dependent Care Flexible Spending Accounts – Set aside money pre-tax to help pay for out-of-pocket health care expenses and/or daycare expenses.
• Public Service Student Loan Forgiveness – The State of Maine is a qualified employer for this federal program. For more information, visit the Federal Student Aid office.
• Living Resources Program – Navigate challenging work and life situations with our employee assistance program.
• Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receive six weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.
• Voluntary Deferred Compensation – Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.

State employees are eligible for an extensive and highly competitive benefits package, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.

Equal Opportunity Employer

As an Equal Opportunity employer, Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members, and our process ensures an inclusive environment to applicants of all backgrounds including diverse race, color, sex, sexual orientation or gender identity, physical or mental disability, religion, age, ancestry, national origin, familial status or genetics.

Accommodations

Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.

Alternative Submission Options

If you are unable to complete the online application, please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting.