Patient Financial Advocate

3 weeks ago

Albuquerque, United States Presbyterian Healthcare Services Full time
Overview

Join our team as a Patient Financial Assistance

  • 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

Ideal candidate:  Three to Five years experience in hospital setting or physician office, knowledge of insurance benefits, attention to detail, great communication skills and understand complex financial and admission information. 

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us:

Full Time - Exempt: No Job is based Presbyterian Hospital Work hours: Weekday Schedule Monday-Friday

Benefits:  We offer a wide range of benefits including medical, wellness programs, vision and dental, paid time off, retirement and more. 

Qualifications

Experience:

Three to five years of healthcare experience in a physician office or hospital setting.

  • Prior billing office and collection experience preferred.
  • Significant provider and patient interaction experience

Abilities:

  • 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

Education Essential:* High School Diploma or GED

Responsibilities

Customer Service and Caring Practices:

  • 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

Encounter Components:

  • 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

Financial Accountabilities:

  • 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.

Medical Record Components:

  • Documents patient discussion, agreed upon outcomes and audit trail note in guarantor account notes or the auth/cert screen as applicable.

Patient Relations

  • Comprehend quality service connection to patient satisfaction and reimbursement
Benefits

We offer more than the standard benefits

For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services:

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity

Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

#NCS123

Maximum Offer for this position is up to USD $23.07/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

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