Job Summary:Are you detail-oriented, analytical, and ready to make an impact in healthcare? Join our team as an Accounts Receivable Resolution Specialist and help ensure timely and accurate reimbursement while supporting our revenue cycle operations.

Job Description:

The Role:
As an Accounts Receivable Resolution Specialist, you’ll prepare and submit claims, resolve denials and incorrect payments, and ensure timely reimbursement. You will play a key role in collaborating with internal teams and communicating with patients to secure accurate insurance coverage and resolve billing issues.

Key Responsibilities:

Claims Processing: Prepare and submit claims in paper or electronic formats based on departmental and payer guidelines. Review and edit claims for accuracy, ensuring correct diagnosis and procedure codes.Denial Management: Review and resolve claim rejections, denials, and appeals. Prepare secondary and tertiary claims as required.Insurance Verification: Determine and verify insurance coverage and coordination of benefits. Obtain retro-authorizations when needed.Billing and Reporting: Prepare and review billing reports, audits, and worklists to ensure timely and accurate billing, re-billing, and charge corrections. Collaborate with multidisciplinary teams to address complex cases.Patient Communication: Communicate with patients to secure accurate insurance coverage and resolve any coordination of benefit issues.

Qualifications:

Relevant Experience: Minimum of 2 years in Healthcare Insurance Follow-Up, Medical Billing, or a related field.Knowledge of Medical Billing Procedures: Familiarity with claim submission, coding, and insurance verification.Attention to Detail: Strong focus on accuracy for reviewing and editing claims to comply with payer guidelines.Problem-Solving Skills: Ability to identify and resolve claim issues and payment discrepancies effectively.Communication Skills: Exceptional verbal and written communication skills to liaise with patients, insurance carriers, and internal teams seamlessly.

Scheduled Weekly Hours:40

Scheduled Work Shift:

Job Exempt: No

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:An employee discount program is available to all employees for services provided by MaineGeneral Medical Center.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.

Equal Opportunity Employer M/F/Vet/Disability  Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 .