Medical Billing Specialist

DaMar Staffing; Augusta (ME); On-site; USD 52,000 - 70,000; Full time

Benefits offered by this job

Health Insurance Coverage

Retirement Plan

Vacation leave

Job summary

The State of Maine is seeking an experienced Reimbursement Specialist to perform medical billing and insurance reconciliation for two State psychiatric hospitals in Augusta. This full-time role requires a Bachelor's degree in Accounting or related field and at least one year of health care insurance experience.

Responsibilities include creating claims, posting payments, and coordinating with providers, agencies, and customers.

Qualifications

• Bachelor's degree in Accounting, Business Administration, or related field; 1 year experience in health care insurance required.
• Directly related work experience may substitute for education on a year-for-year basis.
• Knowledge of medical billing practices, medical terminology, ICD-10, and CPT coding preferred.

Responsibilities

• Create and send medical claims to government and private insurance on behalf of the State's two psychiatric hospitals.
• Reconcile insurance transactions, follow up on accounts receivable and post payments.
• Assist providers with overpayment repayments and recovery of funds while adhering to HIPAA and regulations.
• Handle calls, respond to correspondence, negotiate payment arrangements, and verify transaction history across systems.
• Record all communications and actions in the CRM and other record systems.

Skills

Medical billing

Medical terminology

ICD-10

CPT coding

HIPAA compliance

Customer service

Negotiation

Education

Bachelor's degree in Accounting

Bachelor's degree in Business Administration

Tools

Medical billing software

Electronic medical records

Microsoft Office Suite

Job description

Reimbursement SpecialistAre you an experienced accounting professional who enjoys medical billing functions? Are you detail oriented and enjoy independent work in a dynamic, fast-paced environment? Do you possess a high degree of initiative? Then we are looking for you!This is a full-time position located in Augusta.Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

Core Responsibilities

• Creating and sending medical claims to government and private insurance agencies on behalf of the State's two psychiatric hospitals.
• Reconciliations of all insurance related transactions, communicating with internal and external agencies and customers, accounts receivable follow-up, and posting of payments received.
• Working directly with providers/clients to support their overpayment repayment efforts and maximizing funds recovered, while adhering to all State and Federal rules and regulations.
• Handling both incoming and outgoing collection calls, responding to written member or provider correspondence, negotiating payment arrangements, researching transaction history, and working with internal/external teams to ensure the accuracy of member accounts.
• Collaborating with internal and external customers, fully noting all correspondence and action taken on customer accounts in the Customer Relationship Management (CRM) platform as well as any other required system of record.

Minimum Qualifications

A Bachelors Degree in Accounting, Business Administration, or related field and one (1) year experience in health care insurance or related insurance field.

Directly related work experience may be substituted for education requirements on a year-for-year basis.

The backgrounds of well-qualified candidates will demonstrate the following competencies:

1. Prior experience and/or education which demonstrates a knowledge of medical billing practices, medical terminology, ICD-10, and CPT coding.
2. Understanding of insurance guidelines including private insurance companies, Medicare and Medicaid as well as comprehension and upholding of patient confidentiality laws through HIPPA compliance.
3. Prior experience with medical billing software, electronic medical records, and Microsoft Office Suite.

Experience and knowledge of customer service, negotiations techniques, the ability to communicate clearly and effectively both orally and in writing.

Agency Information

The DHHS Financial Service Center is responsible for program accounting, cash management and revenue/expenditure controls for the Department of Health and Human Services (DHHS). The Service Center provides budgetary and fiscal analysis for many complex areas within DHHS, including TANF (i.e., Temporary Assistance for Needy Families) and MaineCare (Maine's Medicaid Program). The Service Center works collaboratively with senior leadership at State agencies, providing consultative financial and accounting services. Areas of fiscal expertise include compliance with State and Federal laws and regulations, statewide budgetary policy, budget development and monitoring, application of generally accepted accounting and financial practices, grant management, financial analysis, cash management, accounting and financial processing, and legislative support.

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.
• Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full‑time.

There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants demonstrate job requirements in differing ways, and we appreciate that many skills and backgrounds can make people successful in this role. 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. If you're looking for a great next step, and want to feel good about what you do, we'd love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request. 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.