Overview To research and resolve complex claims issues which cross interdepartmental lines and communicate the outcome to providers and affected Partnership managers. Develops and maintains provider training materials for all lines of business. Conducts provider trainings across
Job Summary:As a Compliance Specialist, youll play a critical role in overseeing the MaineGeneral Health Compliance Program, supporting departments with expert guidance and ensuring alignment with the federal and state regulations. Our team goes beyond problem-solving;
PRIMARY JOB DUTIES Gathers, updates and verifies insurance/payer information and ensures accurate entry into the practice management system. Verifies insurance type and eligibility for care. Prioritizes referrals based on clinical need as indicated by the ordering
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