Accounts Receivable Resolution Specialist

MaineGeneral Health • Waterville, ME

79d

About The Position

MaineGeneral Health is currently seeking a full-time Accounts Receivable Resolutions Specialist to process accurate payer claims to ensure timely reimbursement and resolves denials of payment and incorrect payments from insurance carriers. This is a fantastic opportunity to join a dynamic team of professionals; while putting your problem-solving, analytical, and attention to detail skills to work helping to ensure timely reimbursement of payments.

Requirements

• 2 years or more work experience in the Healthcare Insurance Follow Up or related field.
• Excellent communication skills.
• Analytical skills and attention to detail.
• Independent problem-solving skills.
• Strong organizational skills and ability to handle multiple tasks at once.
• Proficiency with Microsoft Office products.
• High School diploma or equivalent.

Responsibilities

• Prepares bills in the paper and/or electronic format designated by departmental and payer guidelines and transmits them appropriately.
• Prepares, reviews, and edits claims for accuracy and submission to payers as required, ensuring proper diagnosis and procedure codes.
• Reviews and resolves claim rejections, denials, appeals, and issues, prepares secondary and tertiary claims as required.
• Determines and verifies insurance coverage and coordination of benefits to ensure timely billing and follow-up when claims do not process and pay timely.
• Obtains retro-authorizations as needed and allowed.
• Prepares and reviews routine billing reports, audits, worklists, and collaborates with multidisciplinary teams as necessary to ensure timely and accurate billing, re-billing, and charge corrections.
• Communicates with patients as needed to secure accurate insurance coverage and coordination of benefits.

Benefits

• Quality health, dental, and vision benefits.
• Wellness programs and resources.
• Industry-leading leave for new parents.
• Generous earned time plan.
• Employee Assistance Program for emotional wellness.
• Employee discount program for services provided by MaineGeneral Medical Center.
• Tuition Reimbursement.
• 403(b) company-matching contributions up to 2% of eligible pay.
• 401(a) retirement income plan.
• Short-term and long-term disability insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Nursing and Residential Care Facilities
• Education Level: High school or GED