Insurance Representative - Pre-Arrival

MaineGeneral Health; Waterville (ME); On-site; USD 28,000 - 53,000; Full time

Benefits offered by this job

Payactiv wage access

Tuition Reimbursement

403(b) matching contributions

Disability insurance

Job summary

MaineGeneral Health in Waterville, ME, is hiring a Financial Clearance Specialist responsible for verifying insurance coverage, determining pre-authorization needs, and securing approvals before scheduled services.

You will enter patient insurance and authorization data, inform patients and payers about financial responsibility, and collaborate with patients, clinical staff, and payers to resolve coverage questions and ensure accurate billing.

Qualifications

• Insurance verification and pre-authorization processes
• Accurate documentation of insurance, authorization, and orders
• Clear communication of financial responsibilities to patients and payers
• Collaboration with patients, clinical staff, and payers to resolve coverage questions
• Knowledge of payer policies and authorization workflows

Responsibilities

• Verify insurance coverage and determine if pre-authorization is required for scheduled procedures.
• Enter patient insurance, authorization, and order details into the patient record with complete documentation.
• Notify patients and payers of financial responsibility and any non-covered services.
• Collaborate with patients, clinical staff, and payer representatives to resolve questions about coverage and financial clearance.
• Apply knowledge of payer policies and authorization processes to maintain compliant workflows.

Skills

Insurance verification

Pre-authorization

Documentation

Patient communication

Cross-functional collaboration

Payer policy knowledge

Job description

Job Summary:This role is responsible for verifying insurance coverage and ensuring all required authorizations are in place for scheduled procedures. This position plays a key part in supporting financial accuracy and patient communication before services are rendered.

Job Description

• Confirms insurance coverage and procedure details, determines if pre-authorization is required, and obtains all necessary approvals in advance of the scheduled service.
• Accurately enters patient insurance, authorization, and order/RX details into the patient record, ensuring complete documentation for all services.
• Notifies patients and payers of financial responsibility, communicating any non-covered or non-authorized services to both patients and practitioners.
• Collaborates with patients, clinical staff, and payer representatives to resolve questions regarding coverage limitations and financial clearance.
• Applies strong knowledge of payer policies, coverage criteria, and authorization processes to maintain efficient and compliant workflows.

Compensation Information

$20.25 - $38.52

The hourly pay range shown represents the base pay range for this position. Individual pay is determined based on factors such as experience, qualifications, skills, and market considerations. In addition to base pay, eligible team members may earn additional compensation through shift, weekend, holiday, on-call, and other applicable differentials. We are proud to offer a competitive total rewards package designed to recognize our caregivers and support them in delivering exceptional care to the communities we serve.

Scheduled Weekly Hours

40

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

• Access the wages you’ve already earned before payday with Payactiv, giving you greater flexibility over your finances.
• 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].