Expenditure Specialist II

Patient Advocate Foundation•Hampton, VA

4d•$19 - $21

About The Position

The Expenditure Specialist II works directly with patients and providers who contact Patient Advocate Foundation’s TotalAssist Program for assistance. The role facilitates the claims process by telephone, explains the program’s parameters, and provides professional, compassionate customer service while maintaining strict confidentiality of information obtained through employment with PAF. The specialist processes expenditure requests and claims, verifies eligibility and documentation, enters completed requests into the database, and submits them to Finance for processing. The role also screens calls, informs callers of eligibility, refers patients to alternate resources when needed, meets quality and production benchmarks, and may mentor new team members. Employees are expected to follow PAF policies, procedures, department SOPs, and applicable compliance standards. This is a full-time, non-exempt position in the TotalAssist department and reports to the Operations Supervisor.

Requirements

At least 3 years of professional experience in a healthcare environment, social work, or health insurance.
Excellent oral and written communication skills.
Strong interpersonal skills and ability to work effectively with people across organizational levels.
Ability to enter accurate data while speaking with a patient.
Ability to provide customer service with professionalism and integrity and maintain control during phone intake with compassion.
Ability to handle pressure while remaining focused on operational goals.
Knowledge of Microsoft Office products and operating systems.
Ability to switch tasks at short notice, work independently, remain flexible, and maintain composure under pressure.
Strong attention to detail and quality.
Ability to work in an environment of continuous process and outcome improvement.
Commitment to confidentiality and to following organizational lines of communication.

Nice To Haves

Associate or bachelor’s degree in healthcare or a relevant field.
Healthcare-related certification(s).
Hands-on experience with insurance verification, patient billing, or medical claims processing.
Knowledge of medical terminology.

Responsibilities

Respond to and process patients’ requests for assistance.
Facilitate the claim process to support accurate and prompt payment of claims.
Explain the intent of the program to patients.
Educate approved callers on program guidelines, including diagnosis verification, claims submission, and, when applicable, income verification.
Process assigned expenditure requests promptly and in accordance with program guidelines.
Prepare required proof of expenditures when claims are received and ensure requested expenses comply with program guidelines.
Verify and enter completed expenditure requests into the database and submit them to Finance for processing.
Screen new calls to ensure patients are within the scope of services.
Inform callers of their eligibility for assistance after the application is completed.
Refer callers to alternate resources when the program cannot assist, using referral lists.
Meet established quality, data collection, and production performance benchmarks.
Communicate with the Operations Team Lead when additional guidance or supervisory assistance is needed.
Mentor new team members during their introductory period, answer questions, and provide constructive feedback on their progress to the TotalAssist Director.
Follow PAF policies, procedures, and department Standard Operating Procedures.
Attend PAF-sponsored events when requested.
Perform other duties as assigned.
Follow applicable compliance standards in daily work.