At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.
Central Maine Healthcare is seeking a Claims Processing Rep to join our Team.
This is a full time 40-hour, benefits eligible position. ?
The rate of pay is $20.00 per hour.
The Claims Processing Billing Representative’s responsibility is to process claims in the most efficient method using paper and electronic media in a timely fashion to ensure a positive cash flow for the regional healthcare system. The use of multiple patient accounting systems and claims processing and scrubbing systems are used.
- Education and Experience:
- High School graduate or equivalent.
- Minimum of two years relevant experience, including knowledge of insurance billing and medical terminology
- Thorough understanding of various insurance plans, government agencies, Medicare and Medicaid.
What It’s Like Working At CMH:
We are all about our team members growth and health. That why we prioritize work/life balance, community-based wellness initiatives and tuition reimbursement or student loan repayment for ALL of our team members.
CMH offers a robust benefits package that includes:
- Robust Paid Time Off (PTO) program
- Medical plan with enhanced Tier 1 benefits provided within the CMH system.
- Dental plan
- Vision plan
- Health Savings Account (HSA)
- Basic Life insurance at no cost
- Supplemental Life insurance
- Long-term disability insurance
- 401(k) or 403(b) retirement savings plans
- Tuition IO partnership for student loan repayment assistance and tuition assistance
- Family leave program for Parental Leaves
- Comprehensive Wellness Program
Essential Duties:
1. Review claims using electronic claims software -compliance products, editing and transmitting.
2. Completes processing for claims received on a daily basis.
3. Works with follow-up staff to determine status of rebilled and aging claims.
4. Enters notes on accounts as necessary and accordingly.
5. Follows up on claims that are held for errors on a weekly basis. When appropriate, contacts patients, employers or third-party payers in order to resolve problems.
6. Maintains WIP counts at or below goal.
7. Identifies claim problems to include all denials, claim issues, registration errors and other issues for monthly reporting to individual departments/practices.
8. Stays informed of changes in the insurance industry relative to billing regulations and requirements.
9. Consults with other departments within the regional healthcare system to obtain, and/or verify billing information.
10. Processes and completes all job responsibilities in compliance with regulatory requirements.
11. Works independently to resolve account problems.
12. Demonstrates the ability to be flexible, organized and function well in stressful situations.
13. Communicates clearly and accurately with the Supervisor.
14. Maintains a good working relationship within the department and with other departments of the regional healthcare system.
15. Follows through, in a timely manner, on all action steps requested by supervisor.
16. Provides coverage for other team members and reorganizes workflow as necessary to accomplish this.
17. Assists with projects and other assignments when necessary and offering assistance when possible.
18. Acts as a resource to the entire Claims Processing team, providing training and support as necessary.
- Language Skills:
- Able to effectively communicate in English, both verbally and in writing.
- Strong written and verbal skills.
- Additional languages preferred.
If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!