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:

The Team Lead in Patient Financial Services is responsible for supporting the strategic and operational leadership of the Patient Financial Services department. This position contributes to the financial strength, compliance and overall performance of Revenue Cycle operations by providing leadership for all Patient Financial Services functions, including hospital and physician (provider) services. The Team Lead assists in the facilitation of improvement in the overall quality, timeliness, completeness, and accuracy of Patient Financial Services processes (such as claims processing, payment variances, payment posting, accounts receivable management, financial counseling, and customer service), as well as effectiveness of Patient Financial Services policy, practices and technology platforms.

The position will support overall administration, direction, coordination, and evaluation of Patient Financial Services and is specifically responsible for any of the following:

• Claims Processing

• Claims Edit Management (DNFB)

• Payer Analytics

• Accounts Receivable Management

• Payment Variance Resolution, including Patient and Payer Credits

• Patient Follow Up

• Payment Posting & Reconciliation

• Customer Service

• Collections

• Vendor Management

• 855a and other regulatory requirements

• Denial/Edit avoidance, mitigation and timely resolution

It is critical that this position be highly effective in delivering the services described above and work harmoniously with leaders and staff across the organization. Effectiveness will be measured in terms of measurable results, commitment, staff engagement and customer satisfaction (at all levels).

Essential Duties:

• Contributes to strategic direction and provides assistance in the operation and process design of systems and procedures to ensure efficient functioning of Patient Financial Services.

• Participate in development of industry best practice operating procedures with consistent application in all business units.

• Ensure all compliance and regulatory standards are maintained.

• Contribute to, monitor and oversee operations utilizing industry metrics on a monthly, annual and long-range planning basis. Contribute to the development of metric report cards to quantify improvements in productivity, quality, service and overall financial results.

• Active participation in denial mitigation and revenue preservation activities.

• Achieve annual and periodic goals and key performance indicators in support of Patient Financial Services operations and overall financial performance.

• Assist in the effective coordination with Manager Patient Financial Services and other Revenue Cycle Supervisors to achieve financial and service level goals for the Patient Financial Services business units as well as Central Maine Healthcare.

• Effectively communicate and coordinate with other functional areas to achieve desired service levels.

• Assist and contribute in the drafting and final approval processes for Patient Financial Services policies and procedures.

• Collaborates with patient service leaders to ensure that processes are working effectively, efficiently and accurately.

• Monitor and support daily staff functions in all areas related to the scope of the Supervisor’s responsibility.

• Support technology elements of Patient Financial Services as it relates to revenue cycle and interfaces with clinical and other operational areas. Examples are denials, underpayment, claim scrubbing, AR collections and propensity to pay tools.

• Communicates with other leaders to establish accountability and coordination between Patient Financial Services and other departments.

• At the direction of the Manager of Patient Financial Services, provide formal reports and presentations to Revenue Cycle teams.

• Assist with special analysis and projects as needed.

• Provide support at all supported entities within CMH.

Technology

• Seek and recommend new information technology solutions and or manual changes that support Patient Financial Services departmental functions.

• Work collaboratively with departmental personnel to implement systems and process changes aimed at improving Patient Financial Services performance.

• Ensure compliance with outside regulatory requirements are documented (i.e. 501(r), Financial Assistance, Billing and Collection)

Management Reporting and Monitoring

• Review and analyze on-going Patient Financial Services KPI’s based on computer generated data and manual reports.

• Utilize departmental work plans to monitor initiative and project goals, progress, and outcomes.

Human Resource Management

• Staff Retention: Assesses staff satisfaction and communicates to manager; works with manager to develop and implement strategies to address satisfaction issues; and promotes retention

• Scheduling and employee attendance monitoring

• Staffing needs

• Work with the Manager in the evaluation of staffing patterns and needs

• Identify opportunities to matches staff competency with role expectations

• Supervises human resources within scope of labor laws

Training & Education

• Work collaboratively with area of responsibility to ensure consistency in patient experience for all patients related to Patient Financial Services.

• Work closely with managers and supervisors to identify common areas of deficiencies and create training to correct the noted deficiencies.

• Establish goals with direct reports for organizational and personal development.

Professional Development

• Attend local conferences/seminars to remain current in supporting the needs of the organization.

• Review industry publications to maintain knowledge base and stay current on best practice solutions.

• Maintain current knowledge of regulatory developments involving agencies (CMS, AHA, DHS, and Joint Commission.)

Communication

• Maintains awareness of verbal/ nonverbal communication in interactions with staff, other departments, physicians (providers), patients, families and students

• Collaborates and communicates effectively with all members of the health care team; shares information to ensure staff, physicians, and affected departments are aware of unit changes

• Maintains patient, staff and hospital confidentiality in all communication interactions: written, verbal, electronic and digital

• Demonstrates ability to initiate and manage crucial conversations and coach leadership team/staff in same; resolves and manages conflict

• Utilizes daily huddles to keep channels of communication open. Gives appropriate feedback in a timely manner to questions and concerns.

• Customer Service

• Displays positive attitude. Treats others with honesty and respect. Speaks positively in all customer interactions internal and external.

• Assesses customer service by reviewing and responding to patient satisfaction

Education and Experience:

• Associates degree required, or two (2) years related experience in lieu of, and

• Four (4) years of experience in Finance or Revenue Cycle with demonstrated progressive responsibilities

• Experience supervising at least 2 or more staff

Knowledge, Skills and Abilities:

• Detailed knowledge of privacy and security regulations, confidentiality/HIPAA, payer registration/authorization requirements, State Charity Care compliance, and MaineCare compliance regulations.

• Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10).

• Expertise with regulations and accreditation standards, knowledge of specific state and federal requirements and standards.

• Working knowledge of Medical Record, Financial Services and Healthcare Application technology.

• Demonstrated experience in diagnosing, evaluating and developing corrective actions for problems in operations.

• Able to effect collaborative alliances and promote teamwork.

• Ability to ensure a high level of employee, patient, visitor, and external stakeholder satisfaction.

• Effective organizational, planning, controlling, scheduling and project management abilities.

• Effective Supervisorial and administrative abilities as applied to the management of multiple projects.

• Effective leadership abilities.

• Ability to positively influence change.

• Excellent communications skills, both oral and written.

• Demonstrated ability to work well with diverse people, excellent human relation skills.

• Flexible and able to react to ever changing priorities.

• 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.