Insurance Verifier Financial Counselor
Prime Healthcare
Insurance Verifier Financial Counselor
Prime Healthcare
Acquires and reorganizes underperforming hospitals
Department: Patient Accounting
Schedule: Full Time, Days
Facility: Central Maine Medical Center
Location: Lewiston, Maine 04240
Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute. CMMC also serves as the central Maine base for LifeFlight of Maine, the state's only medical helicopter service.
CMH also includes Bridgton Hospital and Rumford Hospital, two 25-bed critical access hospitals that provide essential care to Maine's rural communities.
As part of its commitment to healthcare education and workforce development, CMH is home to the Maine College of Health Professions, Maine's first nursing and medical imaging school. The private, not-for-profit institution is accredited by the New England Commission of Higher Education and plays an important role in training the next generation of healthcare professionals.
To learn more, visit www.cmhc.org.
The Insurance Verifier/ Financial Counselor is responsible for determining patient liability based on benefits and advises patient of their liability prior to scheduled elective procedures notifies patient(s) of financial responsibility; collection arrangement are made prior to services rendered for all elective care. Verifies insurance eligibility, and benefits for emergent and urgent admissions, procedures or other services ensuring communication of patient responsibility to the patient or responsible party. Verifies and secures accurate patient demographic and insurance information, updating patient account information as needed. Assists patients in making arrangements as needed for patient responsibility by time of discharge for emergent or urgent services. Screens and refers patients for possible linkage to state, county or other government assistance programs as well as Charity or Discounts as per the facility Charity and Discount policies. The Insurance Verifier/ Financial Counselor works closely with Case Management in securing Medicaid/Medical treatment authorizations as needed. Maintains effective communication skills, including verbal, written and telephone. Proficient in mathematical skills.
1. Knowledge of standard insurance companies and verification requirements. 2. Well versed in authorization processes for all payers 3. Ability to multi-task, prioritize needs to meet required timelines 4. Analytical and problem-solving skills 5. Customer Services experience required6. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
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Central Maine Medical Center offers competitive compensation and a reasonable compensation estimate for this role is $20.00 to $21.50 per hour. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Acquires and reorganizes underperforming hospitals
Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.
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