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 requestsReview clinical orders to support service requestsInitiate outbound calls to complete scheduling requestsCommunicates pre-procedure prepsSecure and validate required demographic and insurance informationVerify insurance information and coverageInitiate medical necessity checks as requiredComplete pre-registration activitiesPerform patient estimates as requiredAdvise and secure patient payments prior to serviceRefer patients to financial counselorsProvide exceptional customer serviceComplete Dept/Org education requirementsEnsure accurate data collection and documentationMeets 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 activitiesSecure and validate required demographic and insurance informationVerify insurance information and coverageSecure clinical information to support authorization and referral requirementsSecuring and obtaining appropriate prior authorizations and referralsPerform patient estimates as requiredAdvise and secure patient payments prior to serviceRefer patients to financial counselorsInitiate medical necessity checks as requiredInitiate and obtain Notice of Admissions to insurance payersIdentify, communicate, and resolve findings that do not meet financial clearance guidelinesProvide exceptional customer serviceComplete Dept/Org education requirementsEnsure accurate data collection and documentationMeets performance standards as determined by Department

Education and Experience:

High school graduate or equivalentMinimum 1-2 years of relevant experience preferably in one of the following: scheduling, pre-registration or financial clearance, preferredKnowledge of medical terminology preferredUnderstanding of insurance reimbursement basics

Knowledge, Skills and Abilities:

Strong customer focusAbove average verbal communication skillsAbove average written communication skillsAbility to multitask and prioritize work assignmentsGood time management skillsAnalytical ThinkingGood problem-solving capabilitiesAttention to detailAbility/proficiency to use multiple systems and software applicationsAbility to ask and secure payments from patientsAbility to work across and within Hospital DepartmentsAbility to work with external partners/customers/insurance carriers/clinical mgmt organizationKnowledge of insurance reimbursement basicsBasic 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!