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Job Details

Reimbursement Specialist

Company name
The Maine Human Rights Commission

Location
Augusta, ME, United States

Employment Type
Full-Time

Industry
Healthcare, Insurance, Accounting

Posted on
Jan 08,2019

Valid Through
Apr 23,2019

Profile

Reimbursement Specialist

Augusta

Maine

United States

Full-time

Opening Date: January 7, 2019

Closing Date:   January 22, 2019

Job Class Code: 0441

Grade: 20

Salary: $16.61-$22.38/Hourly

Position Number: 030304182

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? Do you enjoy working collaboratively utilizing the latest Microsoft analytical tools? Then we are looking for you!

Agency information:

The DHHS Service Center (http://www.maine.gov/dhhs/servicecenter/) is responsible for program accounting, cash management and revenue/expenditure control 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). This position is located in Augusta.

Job duties:

The DHHS Service Center is seeking a Reimbursement Specialist to join the Recovery Division’s Benefit Recovery Unit. 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. Examples include member-based benefit debt (fraud, unintentional program violations, etc.), as well as new and existing Medicaid provider-based debt, inclusive of sanctions imposed for poor performance, failure to perform, etc. and social service contract debts.

This is professional services work within the Recovery Division’s Benefit Recovery team. The Benefit Recovery team’s primary responsibility is to maximize funds recovered from individual members who have been overpaid benefits (OFI programs and services including the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), etc.). Overpayments are identified and established by the Fraud Investigation and Recovery Unit and are referred to the Benefit Recovery team for collection. This position is responsible for incoming and outgoing collection calls, negotiating payment arrangements, researching transaction history, coordinating with the Fraud Investigation and Recovery Unit and the ACES Help Desk on member maintenance cases, corresponding with internal and external customers, documentation of action(s) taken, and adhering to all State and Federal regulations. Additionally, this position is responsible for investigating and gathering the required documentation for the recovery of resources (asset reduction, wage garnishment, tax offset, etc.) from individuals, legally liable guardian(s), or legally liable third parties. Responsibilities include conducting investigations on resources of recipients or their legally liable relatives, obligors, fiduciary, guardian, or any legally liable third party.

MINIMUM QUALIFICATIONS:

 A Bachelor’s Degree in Accounting, Business Administration, or related field and one (1) year experience in health care insurance or related insurance field. Directly related work experience may be substituted for education requirements on a year-for-year basis.

Experience and knowledge of customer service, negotiations techniques, the ability to communicate clearly and effectively both orally and in writing,

The backgrounds of well-qualified candidates will demonstrate the following competencies:

1. An ability to be flexible and adjust to business needs while balancing multiple tasks and priorities. Strong time management skills and the ability to meet tight deadlines are essential.

2. Prior experience of providing exceptional customer service with attention to detail which demonstrates the ability to resolve complex issues.

3. Prior experience of negotiating financial terms in a debt repayment environment with proven results.

4. Demonstrated ability to review and analyze data and reach logical conclusions.

APPLICATION INFORMATION:

Please upload a cover letter addressing the four competencies listsed above, resume, and copies of post-secondary transcripts. For questions about this position, please contact Darin Meyers at (207) 629-8825. To request a paper application, please contact Ashley Vigue at Ashley.Vigue@Maine.gov

BENEFITS

Value of State’s share of Employee’s Retirement:

 15.37% of pay   

Value of State-paid Dental Insurance

:  $13.13 biweekly

Value of State-paid Health Insurance*:

Level 1:

  100% State Contribution = $444.68 biweekly (Employee pays nothing)

Level 2:

  95% State Contribution = $422.45 biweekly (Employee pays: 5%)

Level 3:

  90% State Contribution = $400.211 biweekly (Employee pays: 10%)

Level 4:

  85% State Contribution = $377.98 biweekly (Employee pays: 15%)

*The level of actual value of state paid Health Insurance will be based on employee’s wage rate and status with regard to the health credit premium program as of July 1, 2018.

The Department of Health and Human Services is an Equal Opportunity/Affirmative Action employer.  We provide reasonable accommodations to qualified individuals with disabilities upon request.

Company info

The Maine Human Rights Commission
Website : http://maine.gov/mhrc/

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