Administrative Medical Assistant/Billing & Claims Specialist

Join Maine’s newest on-site primary care team and help shape the future of senior healthcare with Evergreen Senior Healthcare of Maine. We deliver comprehensive, personalized medical care exclusively to residents of Woodlands Senior Living communities, ensuring seniors receive exceptional care delivered with dignity, respect, and heart.

We are excited to welcome an individual who genuinely loves the administrative side of healthcare just as much as (or more than!) traditional clinical work. This is not a typical clinical, patient-facing role - the focus is on administrative excellence, coordination, and anticipating provider needs.

In this role, you’ll be the operational heartbeat of our team, working closely with providers to ensure they have exactly what they need, often before they even ask. This position is ideal for an MA who:

• Thrives on detective work and details
• Anticipates provider needs before they’re even spoken
• Finds energy in organization, coordination, and problem solving
• Enjoys building strong relationships with providers, residents, and care teams
• Takes pride in making operations run seamlessly behind the scenes

If you're motivated by autonomy, meaningful connections within a senior living environment, and the satisfaction of knowing your work directly strengthens the delivery of high-quality care, you’ll feel right at home here.

Come join us - where your commitment to excellence, curiosity, and proactive support can truly shape the future of senior health in Maine!

What you will do:

• Ensure all necessary demographic, billing and clinical information is gathered and accurately entered into designated system in a timely manner. Verifies patient insurance benefits and obtains preauthorization/precertification as needed, escalating any issues to Practice Manager.
• Schedules and coordinates patient visits, consultations and required follow-up discussions or visits. Support patient needs by building external referral networks to ensure adequate care is received.
• Collaborate with multidisciplinary teams to coordinate patient care, including diagnostic service orders, medication orders/refills, and referrals.
• Update and maintain accurate patient medical records in compliance with state and federal regulations. Respond to record requests in a timely manner.
• Utilize clinical and coding knowledge to ensure accurate and compliant diagnostic and procedural assignments are captured to optimize reimbursement for professional charges, utilizing ICD-10-CM, CPT-4 and sequencing best-practices.
• Submit accurate and timely claims to payors. Receives payments from payors and performs data entry of payments and      account adjustments. Informs Accounting Supervisor of accounting discrepancies.
• Perform error analysis for denied claims and provides recommendations for process improvements and claim      reimbursement resolution. Escalates concerns to Accounting Supervisor.
• Act as liaison and subject matter expert to internal and external stakeholders, delivering expert guidance and training related to coding systems, required documentation, payer requirements, and industry standards.

What you’ll bring to the role:

• Two or more years of previous experience as a medical biller/coder preferred
• Proficient with Microsoft Office products preferred.
• Must provide proof of immunization/immunity to MMR, Varicella and Influenza
• A current, valid license to operate a vehicle in the state of Maine and a driving record that is satisfactory to the company may be required
• Strong command of the English language with the ability to follow oral and written instructions with precision