Patient Service Contact Center Rep - Full Time!

Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoast Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services.

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

Position Summary:

Responsible for providing exceptional customer service, while demonstrating proficiency in either facilitating
patient access to care (scheduling) or financially securing services to be provided. The role will require
completing tasks and duties associated with either Patient Scheduling or Financial Clearance within the
Patient Service Contact Center.

Essential Duties:

• Patient Scheduling (Hospital Based and Professional Services)

o 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

o 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.

o 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, preregistration 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. I am creating a warming, caring, and non-judgmental environment
ii. I am actively listening and seeking information
iii. I am honest, truthful, and consistent
iv. I am respectful, treating all individuals with dignity and empathy
v. I am serving as a role model, taking both initiative and ownership when appropriate
vi. I am working collaboratively and demonstrating teamwork
vii. I am resilient and adapt to change in positive ways.

• Demonstrated ability to direct and triage in a highly fluid dynamic operational environment.
• Ability to collaborate with all layers of the management/ administration team.

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.