Insurance Representative - Pre-Arrival

MaineGeneral Health • Waterville, ME

7d

About The Position

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. 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.

Responsibilities

• 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

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed