Patient Continuity and Needs Advocate

ChenMed•Berwyn Heights, MD

1d•Onsite

About The Position

The Patient Continuity and Needs Advocate (PCNA) is responsible for supporting eligible patients and their families receive Medicaid and Federal resources that are adherent to State and Federal Policies. Supports Medicaid enrollment; collects demographic documentation and financial data and initiates follow-up procedures when necessary. Identifies and shares, with patient and/or family member(s), opportunities to maximize medical benefits and, when necessary, arranges follow-up appointments to ensure appropriate guidance to health services and application timelines. Utilizes an Electronic Medical Records (EMR) system to gather and store patient information, respond to questions on behalf of the patient and appropriately and timely document patient issues and resolutions. Maintains assigned work queue of patient accounts. Completes relevant patient documentation in compliance with all regulatory agencies, including HIPAA. Performs other duties as assigned and modified at manager’s discretion.

Requirements

Fundamental knowledge and understanding of local, state and federal healthcare benefit services and plans
Ability to build and maintain exceptional customer service relationships with healthcare services agencies, patients, providers and peers
Dependable and time conscience
Flexibility, agility, self-starter, comfortable with frequent changes and innovations
Competent level business acuity
In-depth knowledge and understanding of general/core job-related functions, practices, processes, procedures, techniques and methods
Understanding of member attribution, eligibility and the disenrollment process
Demonstrated skill in customer service and service recovery
Detail-oriented with proficiency in Salesforce
Strong written and verbal communication skills
Positive attitude and the ability to build trust with internal and external partners
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
Spoken and written fluency in English
High School diploma or GED equivalent required
A minimum of three (3) years’ work experience required

Nice To Haves

Knowledge of and experience in working with insurance brokers or agents preferred
Working with seniors a plus
General understanding of Medicare Advantage
BA/BS degree preferred
Additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis.

Responsibilities

Supports Medicaid enrollment; collects demographic documentation and financial data and initiates follow-up procedures when necessary.
Identifies and shares, with patient and/or family member(s), opportunities to maximize medical benefits and, when necessary, arranges follow-up appointments to ensure appropriate guidance to health services and application timelines.
Utilizes an Electronic Medical Records (EMR) system to gather and store patient information, respond to questions on behalf of the patient and appropriately and timely document patient issues and resolutions.
Maintains assigned work queue of patient accounts.
Completes relevant patient documentation in compliance with all regulatory agencies, including HIPAA.
Performs other duties as assigned and modified at manager’s discretion.