Full-Time

Care Team Patient Services Representative

Portland

Posted on 9/27/2025

Martin's Point Health Care

Martin's Point Health Care

501-1,000 employees

Not-for-profit health care organization

No salary listed

No H1B Sponsorship

Portland, ME, USA

In Person

Category
Customer Experience & Support (2)
,
Required Skills
Customer Service
Requirements
  • HS Diploma or equivalent
  • 3+ years experience working in an administrative and/or customer service oriented environment.
  • Experience in a medical environment with patient registration, billing, insurance processing or appointment scheduling preferred.
  • Ability to function independently and professionally
  • Knowledge of medical terminology preferred
  • Basic knowledge of current healthcare benefits and managed care insurance plans, preferred
  • Windows Based Computer skills: data entry and word processing ability
  • Demonstrated telephone etiquette and positive interpersonal skills
  • Ability to handle difficult conversations with patients and internal customers
  • Ability to multitask among phone and face to face despite frequent interruptions
  • Excellent organizational skills
  • Ability to analyze and problem solve
  • Detailed oriented and excellent follow through skills
  • Ability to work with a variety of customers ranging from patients, internal customers: medical staff and other departments, able to collaborate with peers
  • Must be able to work flexible hours which may include weekends, evenings and holidays
Responsibilities
  • Handles all PSR Desktop Management activities
  • Schedules, reschedules and cancels patient appointments
  • Provides phone support to internal and external customers within established quality metrics.
  • Coordinates New Patient Management (distributes packets, maintains records, initial screenings, etc.)
  • Follows Standard Processes and Protocols related to clinical activities (med refills, order follow through/tracking lab reporting)
  • Responsible for Lab results reporting as delegated
  • Responds to patient requests via incoming phone call, portal or written request
  • With Clinical Support, tracks and follows up patient issues
  • Issues pre-appointment lab and health maintenance reminders
  • Manages Web portal communications and patient related portal requests/questions
  • Depending on practice organizational structure, may also handle referrals and serve as subject matter expert on referrals.
  • Completes barcoding/faxing documents to athena (document management), ensuring timely and accurate document classification and filing of documents in patients health record.
  • Participates in process improvement activities
  • Conduct patient check-in and check-out activities as appropriate.
  • Collects copays and outstanding balances
  • Participates in daily huddles and regular team meetings to improve workflows and contribute to improving patient population outcomes
  • Reviews missing slips and creates claims to ensure appropriate billing
  • At some sites will document and refill medications following the guidance given by Patient Knowledge Coupler (PKC)
Desired Qualifications
  • Experience in a medical environment with patient registration, billing, insurance processing or appointment scheduling preferred.
  • Knowledge of medical terminology preferred
  • Basic knowledge of current healthcare benefits and managed care insurance plans, preferred
Martin's Point Health Care

Martin's Point Health Care

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Martin's Point Health Care is a not-for-profit health care organization that provides medical services to individuals and families. Its offerings include a range of primary and specialty care delivered through clinics and care teams, with a focus on coordinated, accessible patient care and preventive services. The company reinvests profits back into the organization to improve care, expand community benefits, and keep services affordable. Unlike for-profit competitors, it emphasizes community health impact and long-term patient relationships, supported by a mission-driven, member- or patient-centered approach. The goal is to improve the health of the communities it serves by delivering high-quality, affordable care and reinvesting earnings to enhance services and access.

Company Size

501-1,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Portland, Oregon

Founded

1981

Simplify Jobs

Simplify's Take

What believers are saying

  • Avoided litigation costs and uncertainty through July 2023 DOJ settlement.
  • Whistleblower award of $3.82M incentivizes internal compliance reporting.
  • DOJ settlement deters competitors from similar Medicare Advantage upcoding practices.

What critics are saying

  • DOJ launches post-2019 False Claims Act probes using Wilbur precedent within 6-12 months.
  • CMS 2024 model cuts reimbursements by validating fewer diagnosis codes in 3-6 months.
  • New whistleblowers sue over DxID vendor HCC additions, penalties exceed $22M in 12-18 months.

What makes Martin's Point Health Care unique

  • Martin's Point operates Medicare Advantage plans in Maine and New Hampshire.
  • Settled $22.48M DOJ False Claims Act case in July 2023 without admitting liability.
  • Whistleblower Alicia Wilbur filed qui tam suit in 2018 exposing risk adjustment issues.

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Benefits

Professional Development Budget

Company News

PR Newswire
Jul 31st, 2023
Martin'S Point Health Care Risk Adjustment Settlement

PORTLAND, Maine, July 31, 2023 /PRNewswire/ -- Today, Martin's Point Health Care announced that it has agreed to a settlement with the U.S. Department of Justice (DOJ) to resolve an investigation related to Martin's Point's Risk Adjustment practices for the payment years 2016-2019. The claims resolved by the settlement are allegations only, and there has been no determination of liability. The settlement is not related to member care or the payment of member claims.Martin's Point worked collaboratively with the DOJ during the course of the investigation. Despite denying liability for the litigation claims at issue, Martin's Point ultimately determined that settlement of this matter was appropriate rather than engaging in the cost and uncertainty of protracted litigation.A spokesperson for the organization commented: "This settlement is not an admission of liability, it instead allows us to avoid the disruption, expense, and uncertainty of litigation. It is important to note that this investigation is unrelated to member care or payment of member claims

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