Job Summary:Researches, analyzes and reconciles reimbursement policies/procedures to ensure optimal reimbursement for public and private payers. Works at a high level of competency and is a resource for resolution of receivables which have processed and may still have a balance or processed and paid incorrectly according to payer contracts.

Job Description:

MaineGeneral Health is seeking a Reimbursement Specialist to join our team. In this role, you’ll support accurate and timely reimbursement by analyzing payor policies, reviewing denied claims, and making recommendations to improve billing processes. You'll also assist with audits, research reimbursement issues, and guide staff on proper coding and billing procedures.

Key Responsibilities:

Analyze reimbursement policies to ensure optimal payments from public and private payors

Review and resolve denied or disputed claims, offering process improvement suggestions

Support third-party audits as needed

Recommend and implement updates to coding and charge practices

Serve as a resource for staff on billing guidelines and reimbursement questions

Train and coach team members on reimbursement best practices

Preferred Qualifications:

Associate’s degree in a related field

3–5 years of billing experience

Familiarity with payer websites and billing software

Strong understanding of insurance programs

Excellent communication and customer service skills

Critical thinking, sound judgment, and the ability to work independently

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 .