Financial Advocate

Advocate Health • Greenfield, WI

6d • $23 - $34 • Remote

About The Position

Acts as a liaison between health services and consumers by educating them about care costs, funding possibilities, and payment options. Educates consumers on the cost of care and helps them plan and manage their financial responsibility. Pre-screens self-pay patients for potential coverage programs and assists patients or family members with financial assistance applications as needed.

The role calculates personalized estimates of patient financial responsibility based on insurance coverage, explains patient liability and relevant insurance concepts, and requests upfront payments or establishes payment arrangements when applicable. It interviews uninsured patients to assess financial needs, identifies assistance programs, supports applications for potential coverage, and follows up to secure funding for health services. The Financial Advocate also works with state social workers and outside eligibility vendors on Medicaid applications.

The position requires knowledge of insurance benefits and payer options, applicable organizational policies, government funding eligibility requirements, charity care processes, and relevant federal regulations. It handles patient interviews and records in a HIPAA-compliant manner, collaborates with operational peers, and serves consumers in settings including virtual visits, bedside, emergency departments, clinics, urgent care, consult spaces, and Financial Resource Specialist offices.

This is a remote, full-time position scheduled Monday through Friday, 8:00 a.m. to 4:30 p.m., for 40 hours per week. The position requires travel and exposure to weather and road conditions, as well as work in a normal office environment. The employee must be able to sit for most of the workday and occasionally lift up to 10 pounds.

Requirements

• High school graduate, GED, or HSED.
• Typically requires 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 various 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 and be exposed to weather and road conditions.
• Ability to sit for most of the workday and occasionally lift up to 10 pounds.
• Ability to operate the equipment necessary to perform the job.

Responsibilities

• Calculate and provide personalized estimates of patients’ financial responsibility based on insurance coverage before service.
• Clearly explain patient liability, including deductibles, coinsurance, copayments, and the effect of non-covered or out-of-network services on out-of-pocket costs.
• Request upfront payment toward self-pay amounts, estimated out-of-pocket costs, and outstanding balances; establish payment arrangements in advance when applicable and explain installment amounts and due dates.
• Interview uninsured patients to assess financial needs, identify assistance programs, coordinate completion of coverage paperwork and 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 comprehensive patient interviews.
• Work with state social workers and outside eligibility vendors to support complete Medicaid applications and maximize eligible funding.
• Maintain working knowledge of insurance benefits, insurance companies, Marketplace insurance options, and new payer sources.
• Educate physician offices and patients on applicable organizational policies, including Financial Assistance Policy, Patient Financial Responsibility, Non-Covered Services, and Deferral of Care.
• 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; comply with charity care policies and processes 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 costs for upcoming services.
• Serve consumers in a range of settings, including virtual, bedside, emergency department, clinic, urgent care, consult, and Financial Resource Specialist office settings.
• Communicate proactively and clearly to management about customer service issues and process improvement opportunities.
• Use scripted notes and clear written communication when documenting in patient accounts.

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, with possible premium pay and incentive pay for select positions.
• Opportunity for annual increases based on performance.
• Career development programs.

What This Job Offers

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