Patient Account Representative - Central Scheduling
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Biddeford, ME 04005
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.
- 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
MaineHealth values diversity and is an Equal Opportunity/Affirmative Action employer. Federal and state laws prohibit discrimination in employment because of race, color, national origin, religion, age, sex, sexual orientation, disability or veteran status.
Employer’s Job# 132056-77436
Please visit job URL for more information about this opening and to view EOE statement.