Patient Access Financial Advocate-ABQ Position Control
About The Position
The Patient Access Financial Advocate performs financial screening for hospital, pre-registration, emergency room, outpatient, high-deductible health plan, and self-pay accounts. The role requires knowledge of financial assistance, Medicaid and other alternate resource programs, payment-plan policies, benefits administration, and Presbyterian Health Services contracts and network arrangements. The advocate reviews pre-billing and pre-adjudication information to help identify patients’ anticipated out-of-pocket expenses and uses knowledge of Presbyterian affiliates and their billing methods to counsel patients and families about financial responsibilities. The advocate uses standardized procedures and CARES Behaviors to resolve patient balances and support reimbursement, researches disputed balances, and escalates chronic no-pay or bad-debt accounts. The position is based at Presbyterian Hospital and works the day shift. It is a full-time, non-exempt role.
Requirements
- High school diploma or equivalent.
- Three to five years of healthcare experience in a physician office or hospital setting.
- Significant provider and patient interaction experience.
- Detailed knowledge of medical-practice operations, including what work is done, how it is done, and why.
- Familiarity with the Affordable Care Act and healthcare’s role in helping patients and families with healthcare costs.
- Ability to interpret data.
- Understanding of billing methodology for an integrated delivery system, including laboratory and other ancillary services.
- Strong keyboarding skills for efficient data entry and documentation.
- Knowledge of Microsoft Office products.
- Pass the EPIC proficiency test with a score of at least 85% at the completion of the Epic Training class.
- Must be at least 18 years old at the time of hire.
Nice To Haves
- Prior billing-office and collections experience.
Responsibilities
- Provide financial screening to scheduled, admitted inpatient, and discharged patients in a hospital setting.
- Confirm patient insurance eligibility and review benefits so the organization and patient understand coverage for services.
- Use cost-estimate technology to prepare estimates and communicate estimated costs to patients and other affected parties.
- Accurately post payments and help create payment plans for upcoming services or outstanding balances.
- Review account details for patient education or correction; review balances and communicate with patients and other affected parties about outstanding amounts.
- Help patients resolve account questions and concerns.
- Coordinate and complete financial-assistance applications for the charity-care program.
- Determine Medicaid eligibility and perform related roles, including EMSA, Baby BOT registration, and certified enrollment counseling for Institutional Medicaid and the Healthcare Exchange.
- Handle walk-in billing and Albuquerque Ambulance billing questions.
- Work with Medicare patients who have an open MSP and screen all Indian Health patients.
- Understand the revenue cycle, including its participants and appropriate escalation pathways.
- Apply knowledge of regulatory agencies and requirements, including JCAHO, Medicare and Medicaid laws, state and federal laws, and hospital and departmental policies.
- Perform other duties as assigned.
Benefits
- Medical, dental, and vision coverage.
- Short-term and long-term disability insurance.
- Group term life insurance and other optional voluntary benefits.
- Employee Wellness rewards program, with opportunities to earn gift cards and other rewards through wellness activities.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
