Patient Financial Advocate

University Hospitals•Shaker Heights, OH

About The Position

As a Financial Counselor, the Patient Financial Advocate helps patients understand and manage the costs of healthcare. The role provides financial counseling to patients and families about insurance coverage, expected costs, financial assistance, Medicaid eligibility, payment options, and other resources that can make care more accessible. The advocate works directly with patients before and after services, partnering with providers, community agencies, and internal teams to support financial clearance, accurate estimates, reimbursement, and a positive patient experience while meeting organizational and regulatory requirements. The role supports patient access to care by explaining estimates and financial responsibilities, exploring assistance and coverage options, helping patients with Medicaid and other enrollment processes, and resolving financial questions. It also contributes to community outreach, process improvement, department projects, reporting, analytics, training, and performance initiatives. Financial counseling activities must comply with applicable requirements, including the No Surprises Act, Good Faith Estimate requirements, financial assistance requirements, CMS guidance, Medicaid requirements, and organizational policies. The advocate must protect patient privacy and securely handle Protected Health Information (PHI). Additional responsibilities may be assigned based on department needs.

Requirements

High school equivalent or GED required.
At least 3 years of experience in revenue cycle, patient access, patient financial services, healthcare reimbursement, financial counseling, or a healthcare-related field required.
Proficiency in knowledge of managed care insurance requirements.
Proficiency in knowledge of Price Transparency, Good Faith Estimate, and No Surprises Act requirements.
Proficiency in knowledge of Medicaid eligibility, enrollment processes, presumptive eligibility, and public assistance programs.
Investigative and research skills to identify financial options for patients.
Exceptional written and verbal communication skills.
Proficiency with digital systems, applications, and workflow tools.
Advanced knowledge of medical billing and claims terminology and workflow processing.
Advanced analytical and problem-solving skills.
Exceptional client service, communication, patient advocacy, and relationship-building skills.
Ability to educate patients about insurance coverage, financial responsibility, and available financial resources.
Ability to work independently, stay self-motivated, and perform in a fast-paced environment.
Proficiency with Epic, HIS systems, estimation tools, eligibility systems, Microsoft Office Suite, and general office equipment.
Experience with pre-service collections, payment plans, and patient financial advocacy.
Ability to meet the listed physical demands: sitting and talking and hearing constantly; repetitive motions and eye/hand/foot coordination frequently; standing, walking, handling, and grasping occasionally; and lifting, carrying, pushing, pulling, climbing, balancing, stooping, kneeling, crouching, crawling, reaching, and feeling rarely. Listed lifting, carrying, pushing, pulling, and climbing demand is rarely up to 20 lbs.
Travel requirement listed as 10%25.

Nice To Haves

Associate's degree in Healthcare, Business, Revenue Cycle, Social Services, Public Health, or a related field.
Experience with medical billing software.
Experience with patient estimates, Good Faith Estimates, financial clearance activities, financial assistance programs, Medicaid enrollment, or eligibility programs.
Certified Healthcare Access Associate (CHAA).
Ohio Certified Application Counselor or equivalent Medicaid enrollment certification.

Responsibilities

Provide compassionate, timely financial counseling and support to patients before scheduled services.
Prepare and explain patient estimates and Good Faith Estimates (GFEs).
Explain deductibles, copayments, coinsurance, out-of-pocket costs, insurance benefits, coverage limitations, out-of-network benefits, reference-based plans, and self-pay options.
Conduct financial counseling appointments for IVF and other specialty services.
Help patients establish payment arrangements, explore financing options, and make initial payments when appropriate.
Conduct pre-service financial clearance and collection activities, and proactively contact patients who may need additional financial support.
Identify financial or reimbursement concerns early and connect patients with appropriate solutions or additional review.
Help patients understand and apply for hospital financial assistance programs, including application and documentation requirements.
Assess financial hardship and identify programs and resources that may help patients.
Assist with Medicaid applications, renewals, redeterminations, eligibility verification, presumptive eligibility screenings, and enrollment; follow pending applications through eligibility determination.
Serve as an Authorized Representative for patients when properly designated.
Partner with county agencies, managed care organizations, government agencies, and community resources to help patients access coverage.
Educate uninsured and underinsured patients about Medicaid, insurance, financial assistance, and other available resources.
Listen to patient concerns, research account questions, and provide clear solutions and next steps.
Manage inbound and outbound financial counseling calls and answer questions about estimates, insurance coverage, Medicaid, payment plans, financial assistance, billing concerns, and financial clearance.
Connect patients with Customer Service or other departments when additional assistance is needed, help ensure a smooth handoff, and escalate sensitive or complex concerns to the appropriate team.
Create a positive patient experience through education, communication, empathy, and financial advocacy.
Participate in community outreach events, health fairs, enrollment programs, and educational activities.
Support efforts to expand healthcare access and connect uninsured patients with available resources.
Review reports, worklists, and account information to identify opportunities to improve processes and the patient experience.
Contribute ideas for improving workflows, technology, financial counseling practices, and patient engagement.
Support department projects, reporting, analytics, and performance initiatives, including initiatives involving Revenue Cycle performance, enrollment, and health equity.
Assist with training, mentoring, and onboarding as assigned.
Stay current on industry practices and share opportunities for improvement with leadership.
Ensure financial counseling activities follow applicable requirements and organizational policies, including the No Surprises Act, Good Faith Estimate requirements, financial assistance requirements, CMS guidance, and Medicaid requirements.
Protect patient privacy and securely handle PHI in accordance with required training, the UH Code of Conduct, and organizational policies and procedures.
Perform additional responsibilities based on department needs.