Patient Financial Advocate-ABQ

Presbyterian Healthcare Services•Chattanooga, TN

9d•$16 - $24•Onsite

About The Position

Now hiring a Patient Financial Advocate-ABQ Summary: Performs financial screening on hospital and medical group account activity to identify residual balances, high-deductible plan participants and self-pay patients Requires thorough knowledge of assistance programs to include Community Benefit Application, Medicaid (PEMOSSA) application where applicable and other alternate resource programs in addition to full competency of Presbyterian policy for payment plan application Research disputed account balances and resolve accounts with outstanding residual balances Must possess in depth understanding of benefits administration of PHS contracts and their respective in and out of network arrangements Comprehension of the pre-billing/pre-adjudication of claim filing to successfully identify out of pocket expense to counsel patient and/or families regarding financial responsibilities to Presbyterian Escalates chronic no pay or bad debt accounts to supervisor Refers patients without insurance coverage to the Financial Advocacy Center located at Main PHS for navigation of options to manage healthcare costs, including using the Market Place for obtaining health insurance coverage Other duties as assigned

Requirements

High school or equivalent
Three to five years of healthcare experience in a physician office or hospital setting
Prior billing office and collection experience preferred
Significant provider and patient interaction experience
Demonstrates a commitment to Presbyterian s Sense of Mission by role modeling CARES Behaviors and appropriate customer service techniques to perform patient education and act as a resource and advocate to our patients and members
Requires detailed knowledge of operations in a medical practice in terms of what and how work is to be done as well as why it is done
Familiarity with the Affordable Care Act and healthcare s role in assisting patients and patients families with health care costs
Must be able to interpret data
Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope

Responsibilities

Customer Service and Caring Practices: Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools. Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times Ability to manage conflict and appropriately request the help of a supervisor when appropriate
Encounter Components: Calculate patient out of pocket expenses (copayment, coinsurance, residual, deductible etc.) Use workflow to adjust the DAR (Epic Dept Appointment Report) to alert registration staff of residual amounts for appointed patients In one on one patient interactions set expectation for payment when applicable Set up payment plans in Epic per guidelines Registration accuracy skills to insure correct coordination of Exceptional registration accuracy skills to identify errors and correct them as necessary. Serves as a resource to staff regarding account interpretations. Identify claims where filing errors have occurred and resubmit the claims to payors for consideration
Financial Accountabilities: Collects identified patient financial obligation amounts including residual balance if applicable In one on one patient interactions set expectation for payment when applicable Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center Follows PMG cash handling policies and balances daily Keeps current on PHS financial policies, including payment plans, programs and other forms of funding
Medical Record Components: Documents patient discussion, agreed upon outcomes and audit trail note in guarantor account notes or the auth/cert screen as applicable.
Patient Relations Comprehend quality service connection to patient satisfaction and reimbursement
Patient Safety Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist in any manner the clinic team directs. Ensure registration area, waiting area and walkways are clear of any unnecessary items and are clean and neat. Report any concern that may create a safety issue. Annual competency completion of Clerical Staff during a Code Blue
C.A.R.E.S Behaviors: Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter
Professional Requirements: Pass annual competency exam for all areas of responsibility. Attend Quarterly MSO meetings. Attend Staff meetings Attend Employee Forums

Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

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