Patient Access Specialist

At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.

Position Summary:

Reporting directly to the Patient Access Manager, the Patient Access Specialist performs patient admitting and registration activities in accordance with established hospital and departmental regulations, policies and procedures. This position is responsible for monitoring and managing the EMPI (Enterprise Master Patient Index) during periods of system downtime and/or hours of non-coverage in the HIM department to include: communications with all areas of the healthcare system affected by duplicate medical record numbers, merging of the duplicate medical records and unmerging as necessary.

Essential Duties:

+ Completes patient admission/registration process by reviewing all inpatient accounts for completeness and accuracy of the minimum data set (MDS) as well as all required documents. Obtains and documents missing information required for completion of the admission/registration.

+ Uses appropriate work drivers, including just-in-time face sheet prints, to identify admitted patients and review all accounts.

+ Interviews all inpatients (or appropriate responsible persons) who do not have complete MDS information, and/or all required documents, in order to obtain complete and accurate demographic and financial information.

+ Refers all appropriate non-sponsored patients to Program Eligibility Representative.

+ Monitors regional patient and/or guarantor name changes to ensure appropriateness. Communicates inappropriate changes to Supervisor.

+ Receives inter-facility patient transfer information, performs registration and coordinates bed assignment with Nursing Supervisor.

+ Performs ambulance registrations and charge posting within designated deadlines in order to assure revenue is recorded accurately and in a timely fashion.

+ Maintains insurance and employer master files to reflect most current data. Processes faxed copies of insurance cards and updates patient accounts within 24 hours of receipt of fax.

+ Accessible for registrations, patient transfers and/or EMPI functions during entire shift, using a pager as necessary to meet position requirements.

+ During periods of system downtime and/or hours of non-coverage in HIM Department, performs the following key activities:

+ Maintains communication systems for notifying other departments in the event of duplicate medical record number assignment occurring in a real time environment.

+ Accurately distinguishes between surviving and retiring patient medical record numbers to assure synchronization throughout the organization.

+ Performs medical record number merges or "uncombines" in several different electronic medical systems.

+ Performs transfers of patient account information and is able to follow procedure in terms of understanding which type of transaction should be performed depending upon the circumstances of an inaccurate medical record number assignment.

+ Updates patient demographic, financial and compliance information in the McKesson system.

+ Communicates with patients, medical staff and social workers in a confidential, professional manner using tact and diplomacy.

+ Facilitates the collection of co-pays, deductibles and deposits from patients and their families as appropriate. Works with the Insurance Verification team to communicate and advise on patient responsibility.

+ Performs Program Eligibility Specialist duties as required, during absences.

+ Received constructive feedback from the Supervisor and incorporates it into daily operations. Participates in quality reviews.

+ Attends required meetings, workshops and in-services.

+ Performs other duties as assigned.

+ Customer Service: Interacts with all individuals in a consistent manner, providing attention, support, and assistance to foster an environment of exceptional personal service.

+ Maintains a pleasant and helpful demeanor, and presents a professional appearance toward all internal and external customers at all times.

+ Consistently initiates interaction to provide assistance to individuals who may not be direct customers of the employee (i.e. asks patients who appear to be lost if they need assistance in finding their way).

+ Takes appropriate action to recover from a service difficulty, ensuring that the necessary action is taken to affect a resolution to the customer's problem.

+ Conducts all work activities with respect for coworkers, including the maintenance of a pleasant and professional environment, fostering calmness during stressful situations.

+ Interacts with supervisory personnel in a professional, supportive and courteous manner, venting emotions appropriate to time and place.

+ Demonstrates a commitment to service by consistent attendance and punctuality, scheduling absences according to departmental requirements, and incurring unplanned absences only when unavoidable circumstances exist.

Education and Experience:

+ High school graduate or equivalent.

+ One to three years relevant experience preferred, including knowledge of admitting and registration policies and procedures.

+ Detailed knowledge of department locations and services provided at Central Maine Medical Center preferred.

Knowledge, Skills and Abilities:

+ Able to effectively communicate in English and preferably in French, both verbally and in writing.

+ Additional languages preferred.

+ Proficient skills with personal computers and word processing.

+ Able to communicate effectively with professional staff, families and patients.

+ Detail oriented with a high degree of accuracy.

+ Demonstrates a keen understanding of the significant patient safety implications of maintaining a unique patient identifier in the electronic medical record environment.

+ Ability to multi-task and work under pressure.

+ Ability to engage patients and team members utilizing the CMH Experience Standards

+ I am creating a warming, caring, and non-judgmental environment

+ I am actively listening and seeking information

+ I am honest, truthful, and consistent

+ I am respectful, treating all individuals with dignity and empathy

+ I am serving as a role model, taking both initiative and ownership when appropriate

+ I am working collaboratively and demonstrating teamwork

+ I am resilient and adapt to change in positive ways.

+ Demonstrated ability to direct and triage in a highly fluid dynamic operational environment.

+ Ability to collaborate with all layers of the management/ administration team.

If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!

AT CENTRAL MAINE HEALTHCARE YOU ARE AT THE CENTER OF EVERYTHING WE DO

Our why, our purpose, drives every decision and action we take as a healthcare system. We strive everyday to deliver exceptional care, and to improve our community. We are a non-profit organization that is breaking the traditional healthcare mold by bringing our patients and their family's high value, low cost, and award-winning care while focusing on creating an exceptional experience for them; all within their communities. To accomplish this, we only hire individuals who are committed to excellence, who embody the principles of our CMH Experience Service Standards, and who are ready to step in and help their fellow team members achieve those exceptional results for our patients, their families, and the community.

Central Maine Healthcare System

The organization is broad in its footprint, with three (3) hospitals in Bridgton, Lewiston, and Rumford, and over 75 individual practices within our Medical Group. Lewiston's Central Maine Medical Center is a certified and award-winning level two trauma center, along with our Central Maine Heart and Vascular Institute and the upcoming highly anticipated launch of our comprehensive state of the art cancer treatment center. Both Bridgton and Rumford Hospitals are four (4) star accredited acute care hospitals, and our Medical Group and Maine Urgent Care Centers have won multiple awards within their specialties. As a system we are a six-time winner of the Leapfrog Safety A Rating since 2019, representing some of the highest quality care and outcomes nationwide. Our awards and accolades are only possible as a result of our commitment to culture, and a focus on safety and inclusion, in each of our patient's experiences and in the experiences we create within our teams.

If you are a person who is looking for a way to give back to your community, to help improve the lives of patients or those who care for our patients, want to be part of a growing organization that is setting the bar for Maine healthcare, apply to join Central Maine Healthcare today!

Diversity and Equal Employment Opportunity

CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.