Patient Service Contact Center Rep

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

*After completing a 6 week in-office training, this is a primarily remote position that has rotating weekend and holiday coverage*

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!