Patient Financial Advocate

Premier Medical Resources•Houston, TX

3d•Onsite

About The Position

Revenue Cycle Management is looking for a full-time Patient Financial Advocate to join our team! The Patient Financial Advocate is responsible for serving as a front-line subject matter expert within the Commercial Insurance Department. This role provides patients with timely and accurate financial guidance by addressing insurance verification, billing questions, and payment responsibilities. In addition to front-line patient support, the Advocate also assists with back-end operations to ensure financial accuracy, workflow efficiency, and a seamless patient experience throughout the revenue cycle.

Requirements

In-depth knowledge of insurance plans, billing workflows, and revenue cycle operations.
Proven ability to handle sensitive patient conversations with compassion and professionalism.
Strong problem-solving, communication, and conflict-resolution skills.
Proficiency in EHR systems and billing software.
Patient-centered with strong advocacy and customer service skills.
Subject matter expertise across insurance and collections workflows.
Analytical and detail-oriented in handling complex cases.
Collaborative team player and mentor to frontline staff.
Ability to balance patient advocacy with organizational financial goals.
Experience in a provider setting requiring confirmation of information prior to service.
Knowledge of insurance payers and the physician revenue cycle.
High School Diploma or GED
One (1) year of insurance verification experience in a healthcare setting.
One (1) year of patient collections experience, including direct communication with patients/customers.

Responsibilities

Serve as the primary point of contact for patients with complex financial concerns, including insurance, billing, and payment inquiries.
Provide clear explanations of insurance benefits, out-of-pocket responsibilities, and payment options.
Guide patients through financial assistance programs, Medicaid eligibility, and charity care applications.
Establish and manage patient payment plans with empathy and accuracy, addressing barriers to payment as needed.
Verify insurance coverage, benefits, and coordination of benefits for patients with unique or high-risk cases.
Resolve escalated insurance discrepancies and partner with verification staff on complex cases.
Support prior authorization and pre-certification processes as needed.
Educate patients on billing statements, resolve disputes, and assist with escalated collection accounts to minimize bad debt.
Act as a subject matter expert (SME) across RCM, assisting frontline staff with complex financial questions.
Collaborate with registration, billing, and clinical teams to ensure seamless revenue cycle operations and clean claims.
Collaborate with insurance verification, billing, and collections teams to maintain clean claims and a smooth revenue cycle.
Complete assigned financial queues and department worklists, including posting end-of-day payments, submitting implant payment authorizations, managing pre–bad debt worklists, processing credit balances and refunds, completing SCA submissions, and handling returned mail.
Identify process improvement opportunities and provide feedback to management.
Maintain compliance with HIPAA, payer requirements, and internal organizational policies.
Perform other related tasks as needed.