Patient Service Contact Center Rep 1

2 weeks ago

Lewiston, Maine, United States Central Maine Medical Center Full time

At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.

Essential Duties:

Patient Scheduling (Hospital Based and Professional Services)

The responsibilities include but are not limited to, accurate coordination and appropriate issuance of appointments for hospital-based departments and provider services. In this role, the individual will have contact with patients via phone, hospital departments, practice areas, and external clinical service providers. Scheduling tasks include:

+ Secure and complete inbound scheduling requests

+ Review clinical orders to support service requests

+ Initiate outbound calls to complete scheduling requests

+ Communicates pre-procedure preps

+ Secure and validate required demographic and insurance information

+ Verify insurance information and coverage

+ Initiate medical necessity checks as required

+ Complete pre-registration activities

+ Perform patient estimates as required

+ Advise and secure patient payments prior to service

+ Refer patients to financial counselors

+ Provide exceptional customer service

+ Complete Dept/Org education requirements

+ Ensure accurate data collection and documentation

+ Meets performance standards as determined by Department

Financial Clearance (Pre-Registration, Referral/Authorization/Verification/Estimation

The responsibilities include but are not limited to financially securing an account prior to service delivery. In this role, the individual will have contact with patients via phone, hospital departments, practice areas, Insurance Companies, Medical Review Management Organizations, and external clinical service providers. Financial Clearance tasks include:

+ Secure and complete pre-registration activities

+ Secure and validate required demographic and insurance information

+ Verify insurance information and coverage

+ Secure clinical information to support authorization and referral requirements

+ Securing and obtaining appropriate prior authorizations and referrals

+ Perform patient estimates as required

+ Advise and secure patient payments prior to service

+ Refer patients to financial counselors

+ Initiate medical necessity checks as required

+ Initiate and obtain Notice of Admissions to insurance payers

+ Identify, communicate, and resolve findings that do not meet financial clearance guidelines

+ Provide exceptional customer service

+ Complete Dept/Org education requirements

+ Ensure accurate data collection and documentation

+ Meets performance standards as determined by Department

Education and Experience:

+ High school graduate or equivalent

+ Minimum 1-2 years of relevant experience preferably in one of the following: scheduling, pre-registration or financial clearance, preferred

+ Knowledge of medical terminology preferred

+ Understanding of insurance reimbursement basics

Knowledge, Skills and Abilities:

+ Strong customer focus

+ Above average verbal communication skills

+ Above average written communication skills

+ Ability to multitask and prioritize work assignments

+ Good time management skills

+ Analytical Thinking

+ Good problem-solving capabilities

+ Attention to detail

+ Ability/proficiency to use multiple systems and software applications

+ Ability to ask and secure payments from patients

+ Ability to work across and within Hospital Departments

+ Ability to work with external partners/customers/insurance carriers/clinical mgmt organization

+ Knowledge of insurance reimbursement basics

+ Basic understanding of Revenue Cycle

Ability to engage patients and team members utilizing the CMH Experience Standards

+ I am creating a warming, caring, and non-judgmental environment.

+ I am actively listening and seeking information.

+ I am honest, truthful, and consistent.

+ I am respectful, treating all individuals with dignity and empathy.

+ I am serving as a role model, taking both initiative and ownership when appropriate.

+ I am working collaboratively and demonstrating teamwork.

+ I am resilient and adapt to change in positive ways.

If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application

AT CENTRAL MAINE HEALTHCARE YOU ARE AT THE CENTER OF EVERYTHING WE DO

Our why, our purpose, drives every decision and action we take as a healthcare system. We strive everyday to deliver exceptional care, and to improve our community. We are a non-profit organization that is breaking the traditional healthcare mold by bringing our patients and their familys high value, low cost, and award-winning care while focusing on creating an exceptional experience for them; all within their communities. To accomplish this, we only hire individuals who are committed to excellence, who embody the principles of our CMH Experience Service Standards, and who are ready to step in and help their fellow team members achieve those exceptional results for our patients, their families, and the community.

Central Maine Healthcare System

The organization is broad in its footprint, with three (3) hospitals in Bridgton, Lewiston, and Rumford, and over 75 individual practices within our Medical Group. Lewistons Central Maine Medical Center is a certified and award-winning level two trauma center, along with our Central Maine Heart and Vascular Institute and the upcoming highly anticipated launch of our comprehensive state of the art cancer treatment center. Both Bridgton and Rumford Hospitals are four (4) star accredited acute care hospitals, and our Medical Group and Maine Urgent Care Centers have won multiple awards within their specialties. As a system we are a six-time winner of the Leapfrog Safety A Rating since 2019, representing some of the highest quality care and outcomes nationwide. Our awards and accolades are only possible as a result of our commitment to culture, and a focus on safety and inclusion, in each of our patients experiences and in the experiences we create within our teams.

If you are a person who is looking for a way to give back to your community, to help improve the lives of patients or those who care for our patients, want to be part of a growing organization that is setting the bar for Maine healthcare, apply to join Central Maine Healthcare today

Diversity and Equal Employment Opportunity

CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.

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