Insurance Representative - Pre-Arrival

MaineGeneral Medical Center; Waterville (ME); On-site; USD 28,000 - 54,000; Full time

Benefits offered by this job

Health, dental, vision

Tuition Reimbursement

401(a) plan

Payactiv access

Disability insurance

Paid time off

Career mobility

Job summary

MaineGeneral Medical Center in Waterville, ME is hiring for an Insurance Verification Specialist to verify coverage and secure required authorizations for scheduled procedures. You will enter insurance and order details, notify patients and payers of financial responsibilities, and collaborate with care teams to ensure accurate, compliant financial clearance before services are rendered.

The role emphasizes clear communication, documentation accuracy, and proactive payer coordination to support

Qualifications

• Verifies insurance coverage and determines if pre-authorization is required.
• Enters patient insurance and order details into the record with accuracy.
• Notifies patients and payers of financial responsibility for services.
• Collaborates with patients, clinical staff, and payer representatives to resolve questions.

Responsibilities

• Confirms coverage and procurement of approvals before scheduled services.
• Documents insurance, authorizations and orders properly in the patient record.
• Communicates financial responsibilities to patients and payers clearly.
• Works with care teams and payers to resolve coverage and clearance questions.
• Applies strong knowledge of payer policies, coverage criteria, and authorization processes to maintain efficient and compliant workflows.

Skills

Insurance verification

Pre-authorization

Patient communication

Documentation

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] .

MaineGeneral participates in E-Verify.

Employee Rights E-Verify Participation Equal Opportunity Employer M/F/Vet/Disability: In furtherance of MaineGeneral's policy regarding Equal Employment Opportunity, MaineGeneral has developed a written **Aff** 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 **Aff** Program is updated annually and contains the employer's guaranteed hiring goals for veterans, individuals with disabilities, LGBTQ+ employees, and other underrepresented groups. The ongoing review aims to confirm our continued compliance, training obligations, financial accountability and demonstrates our commitment to inclusive workforce development aligned with statutory guidelines, on average, every year. Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR. EEO is Law