Financial Advocate GCM

Advocate Health • Albemarle, NC

9d • $23 - $34 • Onsite

About The Position

The Financial Advocate calculates and provides patients with personalized estimates of their financial responsibility based on insurance coverage before services. The role explains patient liability, insurance cost-sharing, and the potential costs of non-covered and out-of-network services, and requests upfront payments or establishes payment arrangements when applicable.

The Financial Advocate interviews uninsured patients to assess financial needs, identifies potential assistance and coverage programs, helps patients complete applications, and follows up to secure funding for care. The role initiates credit scoring to assess eligibility for Medicaid, charity care, and other programs, and works with state social workers or outside eligibility vendors on Medicaid applications.

The position requires knowledge of insurance benefits, payer sources, government funding eligibility, and organizational financial policies. The Financial Advocate educates patients and physician offices about relevant policies, coordinates scheduling options based on funding needs, complies with charity care requirements, federal 501R regulations, HIPAA, and applicable patient-interaction regulations, and collaborates with colleagues to support patients concerned about upcoming care costs. Patient interactions may take place virtually or in settings such as the bedside, Emergency Department, clinics, Urgent Care, consult spaces, or a Financial Resource Specialist office.

Requirements

• High school diploma, GED, or HSED.
• Typically requires 2 years of experience in Patient Access, health care, the insurance industry, or a customer service setting.
• Ability to clearly and proactively communicate customer-service issues and process-improvement opportunities to management.
• Ability to explain HIPAA and EMTALA regulations as they relate to patient interactions in the Financial Advocate operational flow, virtually or in person.
• Solid knowledge of how different types of insurance operate in relation to denials and appeals.
• Basic medical coding knowledge.
• Understanding of insurance, billing, and denials.
• Ability to document patient accounts using a combination of scripted notes and clear written communication.
• No licensure, registration, or certification is required.

Responsibilities

• Calculate and provide patients with personalized pre-service estimates of financial responsibility based on insurance coverage.
• Explain patient liability, including deductibles, coinsurance, copayments, and costs associated with non-covered or out-of-network services.
• Request upfront payments toward self-pay amounts, estimated out-of-pocket costs, and outstanding balances; establish payment arrangements and communicate installment amounts and due dates when applicable.
• Interview uninsured patients to assess financial needs, identify assistance programs, help complete coverage applications, and follow up to obtain funding for health services.
• Initiate credit scoring to determine eligibility for Medicaid, hospital-sponsored charity care, and other programs through patient interviews.
• Work with state social workers and outside eligibility vendors to assist with Medicaid applications and maximize eligible funding.
• Maintain working knowledge of insurance benefits, insurance companies, Marketplace options, and emerging payer sources.
• Educate patients and physician offices about applicable financial assistance, patient financial responsibility, non-covered services, and deferral-of-care policies.
• Coordinate with provider offices on scheduling options based on funding needs and clarification of patient financial responsibility.
• Stay current on government funding regulations and eligibility requirements, especially Medicare and Medicaid, and comply with charity care policies and federal 501R regulations.
• Conduct patient interviews and manage demographic information, discussion topics, and actions in a HIPAA-compliant manner.
• Collaborate with peers in the operational flow for uninsured patients and patients concerned about the cost of upcoming services.
• Serve patients in varied settings, including virtually, at the bedside, in Emergency Department rooms, clinic exam rooms, Urgent Care, consult spaces, and Financial Resource Specialist offices.
• Communicate customer-service issues and process-improvement opportunities to management.
• Document patient accounts using scripted notes and clear written communication.

Benefits

• Paid Time Off programs.
• Medical, dental, vision, life, and short- and long-term disability benefits.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Competitive compensation, premium pay for eligible circumstances, incentive pay for select positions, and the opportunity for annual performance-based increases.
• Career development and well-being programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED