Patient Access Advocate II-ABQ

Presbyterian Healthcare Services • New York, NY

5d • $16 - $25 • 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 includes updating demographics, verifying insurance, confirming authorizations, collecting point-of-service liabilities, and documenting benefit analysis and registration information in the ADT system. The advocate follows up on authorizations for scheduled visits and ensures account information is accurate for clean billing. The position may provide coverage in other areas as needed to reduce overtime and avoid registration delays.

The role requires strong knowledge of Medicare (CMS) and other applicable compliance and regulatory guidelines. The advocate monitors accounts for duplications and corrects them before services are provided to support patient safety. They provide customer service to patients and families during registration, offer wayfinding assistance to patients and visitors, explain insurance benefits and liabilities, and help ensure accounts are financially cleared at the time of service.

This is a full-time, non-exempt, day-shift position based at Presbyterian Hospital in Albuquerque, New Mexico.

Requirements

• High school diploma or GED.
• At least one 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 after meeting experience guidelines.
• Strong understanding of insurance and financial account processing.
• Basic understanding of medical terminology and billing codes, including DRG, ICD-10, CPT, and HCPCS.
• Proficiency with the EPIC ADT system.
• General knowledge of the customer encounter process, which may include registration, healthcare practices, financial guidelines, and coordination of benefits.
• Ability to work independently and in a self-directed manner, including with individuals from diverse backgrounds.
• Effective communication skills.
• Analytical and problem-solving skills.
• Knowledge of Microsoft Office products.
• Completion of, or enrollment in, the two-week Patient Access Academy with a passing score of at least 85%.
• Pass the EPIC proficiency test with a score of at least 85% upon completion of the Epic Training class.
• Demonstrated strong keyboarding skills for efficient data entry and documentation.
• Pass annual competency examinations for all areas of responsibility.
• Be at least 18 years old at the time of hire.

Nice To Haves

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

Responsibilities

• Provide an exceptional experience to patients and families using CARES, AIDET, EPE, and PROMISE behaviors.
• Address and attempt to resolve complaints using de-escalation processes, and involve a supervisor when needed.
• Explain insurance benefits and liabilities to patients and help address concerns about hospital financial matters.
• Register patients and accurately obtain, confirm, enter, and update demographic and financial information.
• Review urgent and emergent admission accounts for notification requirements.
• Obtain missing insurance information and verify eligibility and benefits through electronic systems or directly with payers.
• Review accounts and work queues to confirm accurate policy, group, subscriber, authorization, payer, and coordination-of-benefits information.
• Document actions accurately in the system of record and maintain complete, timely records and an effective audit trail.
• Maintain knowledge of authorization requirements, payer guidelines, Medicare (CMS) guidelines, admissions forms, benefit-entitlement verification, and billing requirements.
• Complete the Medicare Secondary Payer Questionnaire (MSPQ) at the time of service when it was not completed during financial clearance.
• Meet productivity standards and recommend ways to improve performance and productivity.
• Monitor and track the Data Quality program and correct errors at the time of service.
• Collect identified patient financial obligations, including residual balances when applicable, and communicate liabilities transparently.
• Educate patients about financial assistance, charity, and other available programs, and refer them to a Financial Advocate or the Financial Advocacy Center as appropriate.
• Complete missing account information to ensure accuracy at the time of the visit.
• Cooperate with risk-management activities and investigations; promptly report suspected or potential violations and cooperate with related investigations.
• Conduct transactions in compliance with company policies, procedures, standards, practices, and applicable legal and regulatory requirements.
• Provide wayfinding assistance to patients and visitors and provide coverage in other areas as needed.
• Attend staff meetings and employee forums, and pass annual competency examinations for all areas of responsibility.
• Perform other duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Short-term disability insurance
• Long-term disability insurance
• Group term life insurance
• Other optional voluntary benefits
• Employee Wellness rewards program offering opportunities to earn gift cards and other rewards through wellness activities

What This Job Offers

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