Patient Account Representative - Central Scheduling

  • Biddeford, ME
  • Southern Maine Health Care
  • Temporary Part Time - Day Shift
  • Clerical/Administrative Support
  • Req #: 132056
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Summary

The Central Scheduling Team at Southern Maine Health Care is seeking a Pre-Certification Representative with prior authorization and strong patient registration experience.

This position is Part Time with flexible/variable hours and days based on business needs. Must be available Monday-Friday between 6:00AM-5:00PM.

Position Summary

  • This position serves as a primary contact for Pre-Certification activities. Handling of patients accounts includes registration, medical necessity and prior authorization activities. Incumbent must possess a high level of working knowledge regarding insurance carrier requirements.
  • Position is responsible for confirming patients’ insurance coverage, eligibility, collect benefits information and perform prior authorization for Outpatient services
  • They must have exceptional verbal and written communication skills with a strong attention to detail; proven organizational skills required.
  • They must conduct all interactions with patient, physician offices and other personnel in a courteous, respectful manner while maintaining confidentiality.
  • All tasks are required to be done per established protocols and accuracy standards while demonstrating the SMHC mission to improve the health and healthcare of the communities we serve.
  • To be successful in this role, the employee must be competent, flexible and adaptive to changes in healthcare delivery and technology.

 

Required Minimum Knowledge, Skills, and Abilities (KSAs)

  • High School graduate or GED preferred.
  • Demonstrated knowledge of medical terminology required. 
  • Experience with an electronic medical record system preferred.
  • Demonstrated knowledge of insurance websites and ability to ascertain eligibility, authorizations and benefit details. 
  • Demonstrated knowledge of medical insurance and their respective billing requirements (IE: Worker’s Compensation, Third Party  Liabilities, Medicare, Maine Care, and all commercial insurances) 
  • Understanding of diagnostic and procedure coding systems IE: ICD-10-CM and CPT Codes/HCPS codes required. 
  • Understanding the insurance precertification process required. 
  • Strong interpersonal and telephone soft skills required. 
  • Advanced experience with emailing, keyboarding/typing and voice-mail systems required.
  • Previous success in positions requiring minimal supervision and strong personal initiative is desirable.
  • Ability to work in a fast paced environment

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow. Our package includes health and dental insurances, paid parental leave, retirement program, generous paid time off, and much more! Our comprehensive array of benefits are competitive, affordable, and include choices that meet specific, but ever changing, needs.

MaineHealth is a not-for-profit integrated health system consisting of eight local hospital systems, a comprehensive behavioral healthcare network, diagnostic services, home health agencies, and over 19,000 employees. It is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.

With a career at any of the MaineHealth locations, you’ll be working with healthcare professionals that truly value the people around them – both within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the wellbeing of our communities and employees. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Our care – and the science behind that care – is top rate. Join us and your abilities will be challenged and enhanced as you take your career to another level.

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