Central Maine Medical Center Lewiston , ME 04243
Posted 2 months ago
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
If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!
Central Maine Medical Center