Patient Financial Advocates - Admitting - Full time 8 Hours Days (8:00am to 4:30pm) (Non-Exempt, Non-Union)

University of Southern California•Arcadia, CA

About The Position

The Patient Financial Advocate provides patients with a positive financial experience by helping them understand insurance benefits and financial responsibility, including when they are unfunded. The role performs account quality control, collects amounts due, explains coverage and benefits in person and by phone, and may assess referrals for appropriateness. The advocate helps patients explore eligibility for government programs, MHSC’s Financial Assistance program, and other options for managing high medical liabilities. The position requires independent judgment and the ability to organize tasks that affect hospital and physician reimbursement. The advocate is expected to uphold Methodist Hospital’s mission, vision, values, and performance standards, while working collaboratively and responding helpfully to customer needs. This is a full-time, 8-hour day position, scheduled 8:00 a.m. to 4:30 p.m. It is non-exempt and non-union. The hourly salary range is $21.00–$24.97.

Requirements

High school diploma or equivalent.
At least one year of prior experience at a health insurance company, medical office, or hospital.
Must be BLS certified or provide a BLS certificate within 30 days of hire.
M.A.B. certification is required; new hires must obtain it within six months of hire.
Complete the Certified Patient Access Course and Specialist Exam within 90 days of hire.

Nice To Haves

Associate degree preferred.

Responsibilities

Be cross-trained and able to work in all areas of Admitting as needed.
Conduct interviews by phone and in person; explain hospital policies; obtain treatment or billing consents and acknowledgements appropriate to the health plan.
Determine patients’ financial status and explain their financial responsibility and rights.
Review accounts for accurate demographic and financial information, including interpreting insurance benefits, and maintain at least a 90% accuracy rate on reviewed accounts.
Ensure the appropriate party is notified to initiate admission authorization, and follow up to obtain approved authorizations for services.
Document activities, communications, and financial arrangements completely and in real time; monitor accounts and record changes, including sending updated information as required by plan guidelines.
Identify potential third-party liability, including Workers’ Compensation, commercial coverage, Medicare coordination of benefits, and Medi-Cal.
Screen patients for financial assistance, charity, or other programs and help complete forms and obtain required documentation.
Calculate and collect cash payments when appropriate, including uninsured-patient deposits and payments under letters or agreements.
Notify appropriate staff, including Care Coordination, Social Services, and Admitting, of screening results and relevant insurance eligibility, limitations, and capitations.
Liaise with Los Angeles County DPSS Medi-Cal representatives to screen patients and complete State and County Medi-Cal forms, including temporary Medi-Cal applications.
Schedule and confirm appointments with patients or responsible parties to discuss applications and required documentation.
Discuss outstanding balances with patients receiving current services and work with customer service on payment plans for older debt.
Participate in gathering data for financial reporting.
Follow safety procedures, operate equipment safely, perform duties safely, and report unsafe conditions or situations.
Remain informed about and comply with HIPAA, EMTALA, the Fair Debt and Collection Practices Act, and other applicable laws and regulations.
Remain informed about HMO, PPO, Medicare, Medi-Cal, and indigent service programs and requirements for timely claim processing.
Perform other duties as assigned or needed.