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Patient Financial Advocate I

2 months ago

Rapid City, South Dakota, United States Monument Health Full time

Job Summary

The Patient Financial Advocate I is responsible for serving as the point of contact for all functions and workflows within Revenue Cycle Pre-Arrival financial management. Through conducting a variety of tasks such as creation of price estimates, counseling patients regarding insurance coverage and benefits, arranging payment plans, assessing referrals for care, handling billing issues with third party payers, and assistance with determining eligibility for resources to assist with management of out of pocket responsibilities, this caregiver assists the patients and families with the navigation of the patient financial journey.

Key Responsibilities

  • Performs and completes the workflows of Pre-Arrival patient financial management functions within Revenue Cycle which may include but are not limited to: Financial Clearance (Pre-Registration, Pre-Arrival Insurance Benefit Management, and Authorization/Referral/Benefit Review); Patient Admission and Registration Support (Inpatient, Outpatient, ED Registration, Insurance verification); Financial Counseling (Price Estimations, Payment Planning and Arrangement, Fund Finding and Resource eligibility, Charity Care Review); Customer Service (Patient collections, Customer service follow-up, Third Party Insurance Follow up, Patient balance resolution).
  • Ensures the Pre-Arrival patient financial management and related financial clearance process is completed timely and accurately per policy and standard work processes and guidelines.
  • Communicate in person and over the phone with all Monument Health patients and families across the organization despite service or specialty need to identify and understand financial, social, and medical requisites necessary to facilitate the Pre-Arrival patient financial management functions and workflows.
  • Gather all relevant information required to process and timely complete financial assistance requests, verifies that all new patient forms are complete and signed, maintains complete and accurate documentation of account transactions and conversations.
  • Works collaboratively with patient and internal and external customers of Monument Health to identify long term resources for funding of healthcare related services in getting applications promptly completed and approved.
  • Counsels patients on all out of pocket liabilities including pre and post service balances.
  • Creates accurate cost of care price estimations and distributes timely according to regulatory requirements and Monument Health policy and standard work expectations.
  • Calculates and collects patient financial liability including preservice deposits, co-payments, coinsurance, and deductible.
  • Establishes appropriate payment arrangements before and at the time of visit. Accepts payment and generates receipts.
  • Communicates financial clearance status and applicable financial decisions with all appropriate parties including the patient, family, referring clinicians, Monument Health clinicians, and appropriate operational leadership.
  • Ensures quality services in self-pay collections is given in accordance to applicable policies, procedures and guidelines. Recognizes accounts that are repeatedly delinquent or otherwise in the absence of acceptable payment terms and regularly recommends placement of account for further collection activity, including legal action, as evidenced by documentation, observation and feedback.
  • Practices safe and secure cash handling practices per Monument Health policy and standard practice guidelines assuring all physical safeguards and other internal controls are maintained.
  • Demonstrates a clear understanding of core business structures, systems, best practices, trends, and technologies within the industry.
  • Understands system and business practice concepts and work approaches used to systematically pursue ever-higher levels of performance. Understands or demonstrates understanding of strategic planning, research, and development and analysis processes Further understands or demonstrates understanding that high-performance work approaches are necessary to align the organization's efforts, as evidenced by improved customer relations' focus, quality initiatives, financial performance, and operational performance.
  • Communicates effectively the pertinent information regarding the financial clearance processes and reimbursement activities with all Monument Health internal and external customers to promote a positive work environment.
  • Actively participates in seeking and developing other educational and skillset opportunities to assist with ongoing personal growth and development and career goals.

Requirements

  • Education - High School Diploma/GED Equivalent in General Studies
  • Preferred: Experience - 1+ years of Healthcare Administration or Operations Experience; 1+ years Billing/Collections Experience
  • Physical Requirements: Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.