Patient Advocate (Financial Counselor)

MNGI•Minneapolis, MN

1d•Hybrid

About The Position

The Patient Advocate (Financial Counselor) is responsible for identifying preauthorization or referral requirements and the corresponding processes to assure compliance. This role involves researching and identifying payment and medical policies from applicable insurance carriers related to specific specialty treatments, procedures, and programs prescribed to patients. The Patient Advocate will track the process of prior authorization, ensure approvals are received in a timely manner, and document all submissions, approvals, denials, and conversations. They will analyze prior authorization denials, determine and execute appropriate next steps, and collaborate with internal departments to identify and implement process improvements for the patient's financial experience. A data-driven approach will be used to identify issues and improve process efficiency, with ongoing reporting to validate program success. Additionally, the role involves establishing and fostering relationships with vendors for access to programs, data, and collaboration opportunities. Any other duties as assigned are also part of the responsibilities.

Requirements

High school diploma or GED required.
Must have at least two years experience in a health care or medical office setting.
Knowledge of Microsoft Office applications.
Compassionate patient care.
Active listening.
Problem solve, prioritization, and critical thinking.
Attention to detail and organization.
Communicate effectively verbally and in writing.
Work independently as well as in a team environment.
Type proficiently and accurately.
While performing the duties of this job, the employee may be required to walk, sit, stand, reach overhead, and bend to the floor.
The employee is regularly required to talk and hear.
The employee is required to use dexterity of hands and fingers to operate a computer keyboard, mouse, and other office equipment.
Specific vision abilities required by this job include close vision and ability to adjust focus.
The employee may be required to lift and transport items up to 10 pounds occasionally.
Employees may be required to travel to other company locations due to staffing and training needs.

Nice To Haves

Associates or Bachelor’s degree is preferred.
NextGen (Electronic Medical Record and Practice Management system) and related software preferred.
Insurance payers preferred.

Responsibilities

Identify preauthorization or referral requirements and the corresponding processes to assure compliance.
Research and identify payment policies from applicable insurance carriers as they relate to the specific specialty treatments, procedures, and programs prescribed to patient.
Identify preauthorization requirements for infliximab infusions, iron infusions, and PillCams, and complete necessary authorizations or corresponding processes.
Research and identify medical policies from applicable insurance carriers as they relate to the specific specialty treatments, procedures, and programs prescribed to patients.
Track process of prior authorization and ensure approvals are being received in a timely manner per department expectations.
Document all submissions, approvals and denials, and conversations with internal and external customers for inter-departmental communication purposes.
Analyze prior authorization denials and determine and execute appropriate next steps.
Collaborate with internal departments to identify and implement process improvements to the patient’s financial experience.
Utilize a data driven approach to identify issues and improve process efficiency while providing ongoing reporting that validates the success of the program.
Establish and foster relationships with vendors to allow access to programs, data, and other opportunities for collaboration.
Any and all other duties as assigned.