Financial Advocate GCM

Advocate Health • Charlotte, NC

7d • $23 - $34

About The Position

The Financial Advocate calculates personalized estimates of patients’ financial responsibility based on insurance coverage before services. The role explains patient liability, insurance cost-sharing, non-covered and out-of-network services, and available payment options. It requests upfront payments and establishes payment arrangements when applicable.

The Financial Advocate interviews uninsured patients to assess financial needs, identifies potential assistance and coverage programs, helps 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 social workers or eligibility vendors to support Medicaid applications.

The position requires knowledge of insurance benefits, payer sources, government funding eligibility and regulations, and organizational financial assistance policies. It educates patients and physician offices about applicable policies and works with provider offices on scheduling when funding or clarification of financial responsibility is needed. The Financial Advocate complies with HIPAA and applicable federal requirements, including 501R, and serves patients in settings such as virtual encounters, bedside, emergency departments, clinics, urgent care, and financial resource offices.

Requirements

• High school diploma, GED, or HSED.
• Typically, 2 years of experience in Patient Access, health care, the insurance industry, or a customer service setting.
• Ability to communicate clearly and proactively with management about customer service issues and process-improvement opportunities.
• Ability to explain HIPAA and EMTALA regulations as they relate to patient interactions in the 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 in patient accounts using scripted notes and clear written communication.
• Ability to travel; the position is exposed to weather and road conditions.
• Ability to operate all equipment necessary to perform the job.
• Ability to sit for the majority of the workday and occasionally lift up to 10 pounds.

Responsibilities

• Calculate and provide patients with personalized pre-service estimates of financial responsibility based on insurance coverage.
• Explain patient liability, including deductibles, coinsurance, copayments, non-covered services, and out-of-network services.
• Request upfront payments toward self-pay amounts, estimated out-of-pocket costs, and outstanding balances; establish payment arrangements when applicable.
• Interview uninsured patients to assess financial needs, identify assistance programs, help complete applications, and follow up to obtain a funding source.
• Initiate credit scoring to assess eligibility for Medicaid, hospital-sponsored charity care, and other programs.
• Work with state social workers and outside eligibility vendors to assist with Medicaid applications and maximize eligible funding.
• Maintain knowledge of insurance benefits, insurance companies, Marketplace options, and other payer sources entering the markets.
• Educate patients and physician offices about applicable financial policies and coordinate scheduling options based on funding needs and patient financial responsibility.
• Stay current on government funding regulations and eligibility requirements, particularly Medicare and Medicaid, and comply with charity care policies and federal 501R regulations.
• Conduct patient interviews and manage demographic data, discussion topics, and actions in a HIPAA-compliant manner.
• Collaborate with peers in the operational flow for uninsured patients and patients concerned about upcoming service costs.
• Serve patients in virtual and in-person settings, including bedside, emergency department, clinic, urgent care, consult spaces, and financial resource offices.
• Communicate issues involving customer service and process-improvement opportunities to management.
• Document in 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
• Financial wellness programs
• Educational Assistance Program
• Potential premium pay, incentive pay for select positions, and annual performance-based increases

What This Job Offers

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