Financial Advocate

Highmark Health • Pittsburgh, PA

6d

About The Position

The Financial Advocate coordinates and assists Allegheny Health Network patients who present a financial risk to AHN related to financial obligations in both technical and professional billing systems. The role serves as an escalated patient contact and initiates outreach to patients with financial risk, while supporting patient satisfaction by following department policies and procedures.

The position helps patients apply for alternative payment programs, processes Financial Assistance applications and related account adjustments or refunds, and maintains accurate account and payer information in the accounts receivable system. It also verifies medical benefits and coordination-of-benefits order, supports accurate and timely claim submission, and maintains effective working relationships with internal and external customers.

Employees must follow applicable ethical, legal, privacy, and information-security requirements, including HIPAA, company policies, and the Code of Business Conduct. The role may involve access to covered information, cardholder data, or other confidential customer information, which must be protected.

Requirements

• Associate’s degree in Billing, Health Care, or a related field; alternatively, three years of coordinator experience/training and/or billing/follow-up experience/training, or an equivalent combination of education and experience, may be substituted.
• Three years of experience performing healthcare registration, patient finance, or customer service.
• Two years of experience with health insurance terminology and principles.
• Customer-service skills.
• Critical-thinking skills.
• Problem-solving skills.

Nice To Haves

• One year of experience in a physician billing or health care claims environment.
• Previous experience interviewing patients and family members.
• AAHAM Certified Revenue Cycle Professional.

Responsibilities

• Initiate patient applications for alternative payment programs, including Medical Assistance, Addison-Gibson grants, COBRA, AHN’s Financial Assistance program, and payment plans; follow up with patients and vendors about these programs.
• Process Financial Assistance applications for approval or denial; identify and process patient refunds related to Financial Assistance; and post appropriate adjustments or retractions to accounts receivable.
• Document pertinent information in the accounts receivable system and ensure accurate demographic and payer information in billing systems.
• Identify unbilled insurance and facilitate claim billing; identify deductibles, out-of-pocket expenses, copayments, percentage payables, preferred providers, and other payer-driven boundaries while maintaining a positive customer-service attitude.
• Identify and verify medical benefits and coordination-of-benefits order; correct or update account fields to support timely and accurate bill submission.
• Maintain excellent working relationships with internal and external customers and communicate as needed with designated contacts.
• Perform other duties as assigned or required.
• Comply with HIPAA, data-security guidelines, applicable laws and regulations, company policies, training requirements, and the Code of Business Conduct.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree