Maine Breast & Cervical Health Claims Specialist

Augusta , Maine , United States | Community & Social Services | Full-time

Apply by: May 8, 2024

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Department of Health and Human Services (DHHS)Medical Care CoordinatorOpening Date: April 25, 2024Closing Date: May 8, 2024Job Class Code: 5055

Grade: 04-16 (Pro / Tech)

Salary: $35,713.60 - $47,132.80 / yr.Position Number: 2000-2404Location: Augusta

Position Location: This is a full-time position located in Augusta. This opportunity allows partial telework with management approval.

The Maine CDC Breast and Cervical Health Program is looking for a Medical Care Coordinator to join our dedicated team, helping to improve the health of eligible people by diagnosing breast/cervical cancer early when it is most treatable, as well as reduce health inequities by improving access to treatment for eligible Maine people diagnosed with breast or cervical cancer. As the medical care coordinator, you will work with clients to help determine program eligibility and answer program and procedure questions for clients and providers. You will coordinate and process provider medical billing and claims submissions, work to resolve errors and discrepancies in medical claims, and provide assistance to medical providers regarding individual claim submission as well as conduct research utilizing the Automated Client Eligibility System (ACES), Maine Integrated Health Management Solution (MIHMS – MaineCare claims processing system), and the MBCHP Data Management and Reporting System (DMRS).

This rewarding position requires strong organizational and time management skills, attention to detail, and the ability to work independently. Compassion and patience are essential due to the subject matter of cancer and female anatomy.

Core Responsibilities

As a key member of the MBCHP team, your core responsibilities will include:

• Perform all aspects of the program’s enrollment process.

• Perform data entry.

• Coordinate multiple MBCHP reports.

• Coordinate claims resolution and payment authorizations for breast and cervical services.

• Answer and return client and provider calls.

• Assist with researching, tracking, diagnosing, and troubleshooting MBCHP-related issues.

  MINIMUM QUALIFICATIONS : (Entry level knowledges, skills, and/or abilities may be acquired through, BUT ARE NOT LIMITED TO the following coursework/training and/or experience).

  A four (4) year combination of education and experience in medical eligibility programs and/or experience which demonstrates interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions, and payment authorization.

  PREFERRED CANDIDATES WILL ALSO HAVE:

• Excellent oral and written communication skills.

• Strong teamwork and customer service skills.

• Ability to maintain confidential client information.

• Ability to use Microsoft Word and Excel proficiently.

• Experience in medical billing and claims.

• Familiar with medical terminology and coding

• Familiar with MaineCare and Medical insurance

Thinking about applying?

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Agency information:

TheDepartment of Health and Human Services (https://www.maine.gov/dhhs/) (DHHS) is dedicated to promoting health, safety, resilience, and opportunity for Maine people. The Department provides health and social services to approximately a third of the State's population, including children, families, older Mainers, and individuals with disabilities, mental illness, and substance use disorders. The Department also promotes public health, operates two state psychiatric hospitals, and provides oversight to health care providers.

The mission for the Maine Center for Disease Control and Prevention (Maine CDC), within which this position is located, is to develop and deliver services to preserve, protect, and promote the health and well-being of the citizens of Maine.

For additional information about this position Becky Lambert, MBCHP Health Program Manager , at 207-446-0745 or rebecca.lambert@maine.gov

*To apply , please upload a resume and cover letter with your application. Please submit all documents or files in PDF format. To request a paper application, please contact Ashley.Smith@Maine.gov (Ashley.Vigue@Maine.gov) .

Benefits of working for the State of Maine:

No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:

• Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays , 12 days of sick leave , and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.

• Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($10,523.28-$12,380.40 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.

• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($350.40 annual value).

• Retirement Plan – The State contributes the equivalent of 13.41% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).

• Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including fathers and adoptive parents—receivesix weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act .

  State employees are eligible for an extensive and highly competitive benefits package (https://www.maine.gov/bhr/state-jobs/compensation-benefits) , covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness (https://www.maine.gov/bhr/oeh/) .

  Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for part-time employment.

There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants demonstrate job requirements in differing ways, and we appreciate that many skills and backgrounds can make people successful in this role.

As an Equal Opportunity employer, Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members, and our process ensures an inclusive environment to applicants of all backgrounds including diverse race, color, sex, sexual orientation or gender identity, physical or mental disability, religion, age, ancestry, national origin, familial status or genetics.

If you’re looking for a great next step, and want to feel good about what you do, we’d love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.