Full job description
Position Overview: Responsible for timely and accurate billing of claims, claim adjustments, and collection of all agency claims in accordance with Department of Health & Human Services Chapter 101 MaineCare Benefits Manual, specifically Chapter III, Allowances for Services.
Duties and Responsibilities:
In alignment with the Agency’s Four Cornerstones of Member Care, Driven Program Integrity, Manage and Develop Staff and Facility Management, this position is accountable for the following key duties and responsibilities:
· Facilitates all billing/invoicing for entire Agency as well as perform other related billing responsibilities for Mainecare and Child Development Services (CDS)
· Maintains all client and billing information in all billing systems (billing codes, Maine Care numbers, addresses, client contract information, billing rates, diagnostic codes, authorizations, etc.)
· Handles all client and payer outreach, phone calls, response to inquiries, etc.
· Manages all MaineCare and CDS denied claims ensures all aged claims are collected upon.
· Handles all denied claim communications, research of denials, non-payments, and processes all rebills, claim adjustments, reversals, etc.
· Ensures timely billing discrepancies/denials are investigated and resolved.
· Maintains all client billing files.
· Examines monthly billing reports to ensure accuracy, completeness and conformance to standards defined within the accounting department.
· Ensures minimal errors when billing.
· Acts as point of contact for all internal and external billing inquiries, research, reporting, etc.
· Assists with analyzing billing data, identifying trends, and investigating variances.
· Assists in year-end audit, internal audits, or all audits by third-party payers.
· Apply agency cash receipts
· Other duties as assigned.
· 2-3 years MaineCare billing experience.
· Intermediate Microsoft Excel user. (Must know how to use formulas functions and pivot tables.)
· Ability to meet deadlines.
· Strong problem-solving skills and attention to detail.
· Strong organization skills.
· Strong verbal and written communication skills.
· High Diploma required; Associates Degree preferred.
· Experience with Mybilling/Remarkable Health/CINC/Financial Edge preferred.
*NOTE: This is a Billing Specialist and Cash Management role*
Job Type: Full-time
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- 8 hour shift
- Day shift
- Monday to Friday
Work setting: / Hybrid work / Office
Ability to commute/relocate:
- Sanford, ME 04073: Reliably commute or planning to relocate before starting work (Required)
- What is your experience level with Microsoft Excel?
Education: / Associate (Preferred)
Experience: / MaineCare billing: 2 years (Required)
Work Location: Hybrid remote in Sanford, ME 04073