Insurance Verifier/Financial Counselor

Overview

Department: Patient Accounting

Schedule: Full Time, Days

Facility: Rumford Hospital

Location: 420 Franklin St, Rumford, ME 04276

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.

Responsibilities

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.  

Qualifications

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)

Employment Status

Shift

Equal Employment Opportunity

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