Patient Advocate II, Gender Care Program

Sutter Health•Palo Alto, CA

2d•$36 - $45•Hybrid

About The Position

This vital role supports our gender diverse and transgender community across Sutter Health. This role is unique and crucial to connecting our patients to the best care in Sutter Health. Knowledge of gender identities and expressions, culturally sensitivity and relevant language, as well as health disparities and challenges this patient population faces are highly preferred. Basic knowledge of medical terminology and basic understanding of gender affirming medicines and procedures preferred. In depth knowledge of insurance authorizations, coverages and must have the ability to contact insurance on behalf of the patient, advocating with insurance companies on authorizations, appeals, and denials. Reaching out and finding other possible options as well as assist patients with applying for assistance. Partners with internal provider’s office to ensure the office is clinically supported and a culturally competent environment for patients to receive safe and equitable care. Provides ongoing support, education, and consultation to patient services staff and supervisors to build and maintain transgender and gender diverse competency and sensitivity in services and interactions. Provides financial counseling to patients and their families. Assists with insurance verification and eligibility, assessment of patient financial requirements and insurance policies, and obtaining preauthorization for all services. Ensures that all patient issues regarding insurance claims and cost of care are handled properly. Gains confidence and cooperation from the patient, their family/support group, and other healthcare providers through competent job performance, attentive monitoring and care, and effective communication. Adheres to all local/state/federal regulations, codes, policies and procedures to ensure privacy and safety while delivering optimal patient care. Collections of financial responsibility. Collaborates with ancillary departments. Hybrid: This role includes rounding in clinics approximately twice per week, partnering with operations teams across Sutter Health and supporting community engagement efforts.

Requirements

HS Diploma or equivalent education/experience
1 year of recent relevant experience
Knowledge of patient accounting functions, billing, and insurance or other third party coverage
Knowledge of insurance and medical terminology
Ability to interpret a variety of data and instructions, furnished in written, oral, diagram, or schedule form
Possess written and verbal communications skills to explain sensitive information clearly and professionally to diverse audiences, including non-medical people
Well-developed time management and organizational skills, including the ability to prioritize assignments and work within standardized policies and procedures to achieve objectives and meet deadlines
Prioritize assignments and work within standardized policies and procedures to achieve objectives and meet deadlines
Work independently, as well as be part of the team, including accomplishing multiple tasks in an environment with interruptions
Identify, evaluate and resolve standard problems by selecting appropriate solutions from established options
Ensure the privacy of each patient’s Protected Health Information (PHI)
Build collaborative relationships with peers and other staff members to achieve departmental and corporate objectives

Nice To Haves

Knowledge of gender identities and expressions, culturally sensitivity and relevant language, as well as health disparities and challenges this patient population faces are highly preferred.
Basic knowledge of medical terminology and basic understanding of gender affirming medicines and procedures preferred.
In depth knowledge of insurance authorizations, coverages and must have the ability to contact insurance on behalf of the patient

Responsibilities

Connecting patients to the best care in Sutter Health
Advocating with insurance companies on authorizations, appeals, and denials
Assisting patients with applying for assistance
Partnering with internal provider’s office to ensure the office is clinically supported and a culturally competent environment for patients to receive safe and equitable care
Providing ongoing support, education, and consultation to patient services staff and supervisors to build and maintain transgender and gender diverse competency and sensitivity in services and interactions
Providing financial counseling to patients and their families
Assisting with insurance verification and eligibility, assessment of patient financial requirements and insurance policies, and obtaining preauthorization for all services
Ensuring that all patient issues regarding insurance claims and cost of care are handled properly
Gaining confidence and cooperation from the patient, their family/support group, and other healthcare providers through competent job performance, attentive monitoring and care, and effective communication
Adhering to all local/state/federal regulations, codes, policies and procedures to ensure privacy and safety while delivering optimal patient care
Collections of financial responsibility
Collaborating with ancillary departments
Rounding in clinics approximately twice per week, partnering with operations teams across Sutter Health and supporting community engagement efforts