Location: Augusta,Maine,United States
Department of Administrative and Financial Services (DAFS)
Reimbursement Specialist
Opening Date: November 13, 2024
Closing Date: November 26, 2024
Job Class Code: 0441
Grade: 20 (P&T)
Salary: $20.68 - $28.88 per hour
Position Number: 02000-2460
Location: Augusta
Are you an experienced accounting professional who is detail oriented and enjoys independent work in a dynamic, fast-paced environment? Do you possess a high degree of initiative? Then we are looking for you!
Core Responsibilities:
As a Recovery Specialist within the Recovery Division, you will be responsible for:
• Building and maintaining provider/ client relationships, fostering teamwork and supporting departmental culture with an emphasis on ensuring exceptional customer service.
• Collaborating with internal and external customers, fully noting all correspondence and action taken on customer accounts in the Customer Relationship Management (CRM) platform as well as any other required system of record.
• Working directly with providers/ clients to support their overpayment repayment efforts and maximizing funds recovered, while adhering to all State and Federal rules and regulations, included in but not limited to the State’s Claims Management Plan (CMP) and the MaineCare Benefits Manual.
• Handling both incoming and outgoing collection calls, responding to written member or provider correspondence, negotiating payment arrangements, researching transaction history, and working with internal/ external teams to ensure the accuracy of member accounts.
• Investigating and gathering required documentation for the recovery of resources from providers, individuals, legally liable guardian(s), or legally liable third parties.
• Reviewing, analyzing and managing all financial data and accounting activity for Medicaid and Social Service Providers.
This position will contribute to the Department’s mission by helping us ensure state and federal funds are utilized in an efficient manner to meet the health and welfare needs of Maine’s citizens. The Recovery Division’s primary scope of work includes, depositing money, establishing receivables, and collecting millions of dollars in identified debt owed to DHHS annually, from a variety of sources.
The work completed in this position contributes to the development of business process and accounting controls to implement and maintain sound fiscal practices, while maintaining working relationships with providers and customers to which you are seeking repayment. This position applies fiscal analysis with an important forward-facing provider/client focus.
Minimum Qualifications:
At least 5 years of directly related work experience in health care insurance or related insurance field -OR- a Bachelor’s Degree in Accounting, Business Administration, or related field and 1 year experience in health care insurance or related insurance field.
The backgrounds of well-qualified candidates will demonstrate the following competencies:
• Experience and knowledge of customer service, collections, and negotiation techniques.
• Possess excellent communication skills and extraordinary attention to detail.
• Demonstrated ability to review and analyze data and reach logical conclusions.
• Knowledge of accounting procedures.
• Ability to prepare clear, concise reports of case findings and summaries.
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Agency information:
The DHHS Financial Service Center is responsible for program accounting, cash management and revenue/expenditure controls for the Department of Health and Human Services (DHHS). The Service Center provides budgetary and fiscal analysis for many complex areas within DHHS, including TANF (i.e., Temporary Assistance for Needy Families) and MaineCare (Maine’s Medicaid Program). The Service Center works collaboratively with senior leadership at State agencies, providing consultative financial and accounting services. Areas of fiscal expertise include compliance with State and Federal laws and regulations, statewide budgetary policy, budget development and monitoring, application of generally accepted accounting and financial practices, grant management, financial analysis, cash management, accounting and financial processing, and legislative support.
Application Information:
Please submit all documents or files in PDF format. Please submit a State of Maine direct hire application, resume, and copies of post-secondary transcripts postmarked on or before the closing date. This job posting and a Direct Hire application can be found on our website: http://www.maine.gov/fps/opportunities/
For more information about this position, please contact Shawn.E.Warren@Maine.gov
To request a paper application, please contact Mandy.L.Harman@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%-95% of employee-only premiums ($11,196.96 - $12,514.32 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 ($387.92 annual value).
- Retirement Plan – The State contributes the equivalent of 13.29% 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—receive six 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, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.
Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full-time.
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.
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