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Maternal Child Health Specialist
2 months ago
Job Summary:
The Maternal Child Health Specialist supports the Labor and Delivery unit through various clerical functions related to patient registration and insurance verification. This role is responsible for ensuring accurate and efficient registration of expecting or laboring patients and newborns, as well as collecting and analyzing demographic, insurance, and other information to ensure financial clearance of scheduled procedures/services.
Key Responsibilities:
- Perform accurate pre-appointment coordination and registration of expecting or laboring patients and newborns.
- Collect and analyze demographic, insurance, and other information from the patient, guarantor, and all other sources to ensure financial clearance of scheduled procedures/services.
- Ensure all compliance requirements are met through the procurement of patient signatures on documents, including but not limited to: Conditions of Admissions, Privacy Practices, TeleHealth Consents, etc.
- Inform patients of hospital policies that govern the revenue cycle, the amount owed by the patients, and explain hospital payment policy.
- Provide patients in need with financial assistance and charity care information when financial counselors are unavailable.
- Maintain a working knowledge of applicable Federal, State, and local laws and regulations, Community Memorial Healthcare Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
- Guard patient confidentiality and protect HIPAA confidential medical information.
- Perform registration functions consistent with Federal, State, and Local regulatory agencies and payer requirements, and organizational policies and procedures, including but not limited to HIPAA privacy and EMTALA practices, DNV, and the No Surprises Act (NSA) mandate.
- Verify patient eligibility from resources provided by third-party payers and portals and other online services.
- Interact and collaborate with hospital departments to resolve issues and analyze necessary information to ensure hospital reimbursement and a seamless patient experience.
- Serve as a mentor to new associates and assist in new employee orientation.
- Serve as a preceptor/trainer to new hires and orientees.
- Perform other duties as assigned.
Requirements:
- High School graduate or equivalent (GED).
- 1+ years of hospital/medical/emergency department, patient registration, or insurance verification experience.
Preferred Qualifications:
- Bilingual (English & Spanish).
- Basic understanding of the core Microsoft Office Suite offerings (Word, PowerPoint, Excel).
- Associate's degree and/or Revenue Cycle certifications.
- Experience within a hospital or clinic environment, a health insurance company, managed care organization, or other healthcare financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service.
- Knowledge of medical terminology and anatomy and physiology is preferable.
About Guidehouse:
Guidehouse is an Equal Employment Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
