Medical Billing & Reconciliation Specialist

State-of-Maine; Augusta (ME); On-site; USD 59,256,000 - 82,752,000; Full time

Benefits offered by this job

Paid holidays

Vacation leave

Health insurance

Job summary

State of Maine is seeking an experienced Reimbursement Specialist in Augusta to manage medical claims and insurance reconciliations. The role requires a bachelor’s degree in accounting or related field plus 1 year in health care insurance, with strong knowledge of ICD-10, CPT coding, and HIPAA compliance.

You will work in a fast-paced governmental environment, interacting with providers, patients, and insurance companies while maintaining accurate CRM records and ensuring timely payments.

Qualifications

• Bachelor's degree in Accounting, Business Administration, or related field with 1 year health care insurance experience or equivalent.
• Knowledge of medical billing practices, ICD-10 and CPT coding.
• Understanding of private insurance, Medicare/Medicaid, and HIPAA compliance.
• Experience with medical billing software, EMR, and Microsoft Office Suite.

Responsibilities

• Create and send medical claims to government and private insurers for the State’s psychiatric hospitals.
• Reconcile insurance transactions, follow up on accounts receivable, and post payments.
• Assist with overpayment recoveries and ensure compliance with state and federal rules.
• Handle inbound/outbound collection calls and negotiate payment arrangements.
• Document all correspondence and actions in CRM and other required records.

Skills

Medical billing

Medical terminology

ICD-10

CPT coding

HIPAA

Insurance guidelines

Microsoft Office

EMR software

Education

Bachelor's degree in Accounting

Bachelor's degree in Business Administration

Tools

Electronic Medical Records

Medical billing software

Job description

State of Maine is seeking an experienced Reimbursement Specialist in Augusta to manage medical claims and insurance reconciliations. The role requires a bachelor’s degree in accounting or related field plus 1 year in health care insurance, with strong knowledge of ICD-10, CPT coding, and HIPAA compliance.

You will work in a fast-paced governmental environment, interacting with providers, patients, and insurance companies while maintaining accurate CRM records and ensuring timely payments.