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: 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 when necessary, 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! AT CENTRAL MAINE HEALTHCARE YOU ARE AT THE CENTER OF EVERYTHING WE DO Our why, our purpose, drives every decision and action we take as a healthcare system. We strive everyday to deliver exceptional care, and to improve our community. We are a non-profit organization that is breaking the traditional healthcare mold by bringing our patients and their family’s high value, low cost, and award-winning care while focusing on creating an exceptional experience for them; all within their communities. To accomplish this, we only hire individuals who are committed to excellence, who embody the principles of our CMH Experience Service Standards, and who are ready to step in and help their fellow team members achieve those exceptional results for our patients, their families, and the community. Central Maine Healthcare System The organization is broad in its footprint, with three (3) hospitals in Bridgton, Lewiston, and Rumford, and over 75 individual practices within our Medical Group. Lewiston’s Central Maine Medical Center is a certified and award-winning level two trauma center, along with our Central Maine Heart and Vascular Institute and the upcoming highly anticipated launch of our comprehensive state of the art cancer treatment center. Both Bridgton and Rumford Hospitals are four (4) star accredited acute care hospitals, and our Medical Group and Maine Urgent Care Centers have won multiple awards within their specialties. As a system we are a six-time winner of the Leapfrog Safety A Rating since 2019, representing some of the highest quality care and outcomes nationwide. Our awards and accolades are only possible as a result of our commitment to culture, and a focus on safety and inclusion, in each of our patient’s experiences and in the experiences we create within our teams. If you are a person who is looking for a way to give back to your community, to help improve the lives of patients or those who care for our patients, want to be part of a growing organization that is setting the bar for Maine healthcare, apply to join Central Maine Healthcare today! Diversity and Equal Employment Opportunity CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.