Job Family:

Admitting Representative

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Maternal Child Health Specialist supports the Labor and Delivery unit through the clerical functions related to patient registration and insurance verification.  Registration functions include Point of Service Collections, demographic and insurance information procurement and verification, health plan benefit review and the delivery of financial assistance resources when applicable. 

Shift: Weekdays 3PM-11:30PM with rotating weekends (day shift) & rotating holidays

Position is onsite at Community Memorial Hospital, Ventura, CA

Essential Functions and Responsibilities

• Performs accurate pre-appointment coordination and registration of expecting or laboring patients and newborns.

• Collects and analyzes demographic, insurance and other information from the patient, guarantor and all other sources to accurately ensure financial clearance of scheduled procedure/services.

• Ensures all compliance requirements are met through the procurement of patient signatures on documents that include but are not limited to: Conditions of Admissions, Privacy Practices, TeleHealth Consents, etc.

• Appropriately informs the patients of hospital policies that govern the revenue cycle, the amount owed by the patients and explains hospital payment policy.

• Financial Counselors are unavailable, the MCH specialist shall provide patients in need with financial assistance and charity care information.

• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Community Memorial Healthcare Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Guards to assure that HIPAA confidential medical information is protected and upheld.

• Performs registration functions consistent with Federal, State and Local regulatory agencies and payer requirements, and organizational policies and procedures, including but not limited to HIPAA privacy and EMTALA practices, DNV and the No Surprises Act (NSA) mandate.

• Verifies patient's eligibility from resources provided by third party payers and portals and other on lines services.

• Interacts and collaborates with hospital departments to resolve issues while also analyzing necessary information that will ensure hospital reimbursement and a seamless patient experience.

• Serves as a mentor to new associates and assist in new employee orientation.

• Serves as preceptor/trainers to new hires and orienteers.

• Performs other duties as assigned

What You Will Need:

• High School graduate or equivalent (GED)

• 1+ years of hospital/medical/emergency department, patient registration OR insurance verification experience.

What Would Be Nice To Have:

• Bilingual (English & Spanish)

• Must have a basic understanding of the core Microsoft Office Suite offerings (Word, PowerPoint, Excel).

• Associate's degree and or Revenue Cycle certifications. 

• Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service.

• Knowledge of medical terminology and anatomy and physiology is preferable.

The annual salary range for this position is $43,400.00-$65,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.