Patient Access Advocate II-ABQ

Presbyterian System Services • Albuquerque, NM

3d • Onsite

About The Position

The Patient Access Advocate II registers patient accounts for government and commercial accounts on the date of service for scheduled and unscheduled visits. The role updates demographics, verifies insurance, handles authorizations, collects point-of-service liabilities, and documents benefit analysis and registration information in the ADT system. The advocate confirms and follows up on authorizations for scheduled visits and ensures accounts contain accurate information for clean billing. They may provide coverage in other areas as needed to reduce overtime and avoid registration delays.

The position requires strong knowledge of Medicare (CMS) and other applicable compliance and regulatory guidelines. The advocate monitors accounts for duplicate records and corrects them before services are provided to support patient safety. They provide customer service to patients and families during registration and offer wayfinding assistance to patients and visitors.

The role includes reviewing and completing account and insurance information, checking eligibility and benefits, documenting actions, meeting productivity standards, collecting patient financial obligations, and educating patients about benefits, liabilities, and financial assistance programs. Advocates follow company policies and legal requirements, participate in risk management and quality improvement activities, and demonstrate CARES behaviors.

Requirements

• High school diploma or GED.
• At least 1 year of work experience in Patient Access and/or billing, plus a strong customer service background.
• Completion and passing of the Patient Access Advocate II Advancement test; the test may be taken every 6 months once experience guidelines are met.
• Strong understanding of insurance and financial processing of accounts.
• Basic understanding of medical terminology and billing codes, including DRG, ICD-10, CPT, and HCPCS.
• Proficiency in the EPIC ADT system.
• General knowledge of the customer encounter process, which may include registration and healthcare practices, financial guidelines, and coordination of benefits.
• Ability to work independently and be self-directed, and to work with individuals from diverse backgrounds.
• Effective communication, analytical, and problem-solving skills.
• Knowledge of Microsoft Office products.
• Completion of, or enrollment in, the 2-week Patient Access Academy with a passing score of 85% or higher.
• Pass the annual competency exam for all areas of responsibility.
• Demonstrated strong keyboarding skills for efficient data entry and documentation.
• Pass the EPIC proficiency test with a score of 85% at the completion of the EPIC training class.
• Be at least 18 years old at the time of hire.

Nice To Haves

• CHAA, CHAM, or other industry-equivalent certification.

Responsibilities

• Register patient accounts for scheduled and unscheduled visits, including entering or confirming demographic and financial information.
• Verify insurance eligibility and benefits, obtain missing insurance details, and review payer, subscriber, coordination-of-benefits, and authorization information for accuracy.
• Confirm and follow up on authorizations for scheduled visits and review urgent or emergent admission accounts for notification.
• Document actions and registration information accurately in the system of record to support follow-up and maintain an audit trail.
• Collect patient financial obligations at the time of service and communicate patient liabilities transparently.
• Educate patients about insurance benefits, financial liabilities, financial assistance, charity, and other available programs; refer patients to financial advocates when appropriate.
• Provide exceptional customer service to patients and families, address complaints, use de-escalation practices, and request supervisor assistance when needed.
• Provide wayfinding assistance to patients and visitors.
• Monitor accounts for duplications and correct them before service to support patient safety.
• Ensure completion of required admission forms, benefit entitlement verification, billing requirements, and MSPQ when applicable.
• Monitor data quality and correct errors at the time of service.
• Meet productivity standards and recommend approaches to improve performance and productivity when appropriate.
• Provide coverage in other areas as needed to minimize overtime and prevent registration delays.
• Cooperate with risk management activities and investigations, report suspected violations, and comply with applicable policies, procedures, standards, and legal requirements.
• Attend staff meetings and employee forums, maintain required competencies, and perform other duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Short-term disability insurance
• Long-term disability insurance
• Group term life insurance
• Optional voluntary benefits
• Employee Wellness rewards program, with opportunities to earn gift cards through wellness activities

What This Job Offers

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