Patient Financial Advocate - Admitting
Presbyterian Health Services
- Albuquerque, NM
- $15.52 per hour
- Permanent
- Full-time
- As a Patient Financial Advocate, you will performs financial screening on hospital and medical group account activity to identify residual balances, high-deductible plan participants and self-pay patients.
- Requires thorough knowledge of assistance programs to include Community Benefit Application, Medicaid (PEMOSSA) application where applicable and other alternate resource programs in addition to full competency of Presbyterian policy for payment plan application
- Comprehension of the pre-billing/pre-adjudication of claim filing to successfully identify out of pocket expense to counsel patient and/or families regarding financial responsibilities to Presbyterian.
- Escalates chronic no pay or bad debt accounts to supervisor.
- Refers patients without insurance coverage to the Financial Advocacy Center located at Main PHS for navigation of options to manage healthcare costs, including using the Market Place for obtaining health insurance coverage.
- Other duties as assigned
- Full Time - Exempt: No
- Job is based Presbyterian Kaseman Hospital
- Work hours: Weekday Schedule Monday-Friday
- Benefits: We offer a wide range of benefits including medical, wellness program,
- Prior billing office and collection experience preferred.
- Significant provider and patient interaction experience
- Demonstrates a commitment to Presbyterian's Sense of Mission by role modeling CARES Behaviors and appropriate customer service techniques to perform patient education and act as a resource and advocate to our patients and members
- Requires detailed knowledge of operations in a medical practice in terms of what and how work is to be done as well as why it is done.
- Familiarity with the Affordable Care Act and healthcare s role in assisting patients and patients families with health care costs.
- Must be able to interpret data.
- Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope
- High School Diploma or GED
- Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.
- Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times.
- Ability to manage conflict and appropriately request the help of a supervisor when appropriate
- Calculate patient out of pocket expenses (copayment, coinsurance, residual, deductible etc.)
- Use workflow to adjust the DAR (Epic Dept Appointment Report) to alert registration staff of residual amounts for appointed patients
- In one on one patient interactions set expectation for payment when applicable
- Collects identified patient financial obligation amounts including residual balance if applicable.
- In one on one patient interactions set expectation for payment when applicable.
- Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center.
- Follows PMG cash handling policies and balances daily.
- Documents patient discussion, agreed upon outcomes and audit trail note in guarantor account notes or the auth/cert screen as applicable.
- Comprehend quality service connection to patient satisfaction and reimbursement