About The Position

The Patient Financial Advocate (PFA) is the hospital’s primary contact for patient billing inquiries, customer service, and financial assistance needs. The role serves as a liaison among hospital patients, providers, and payers on post-care account resolution matters. It explains hospital billing practices, policies, and statements, helps patients understand outstanding balances, and provides superior customer service to the patient community. The PFA assists patients with financial assistance applications, explains their financial responsibilities, and helps them identify ways to resolve account balances. The role communicates with patients in person and by phone and may provide coverage for other departmental positions during vacations or illnesses. Additional duties may be assigned, and responsibilities may change.

Requirements

  • High school graduate or equivalent.
  • Experience of 1–2 years with patient billing and account payment procedures within a healthcare organization is preferred.

Nice To Haves

  • One to two years of experience with patient billing and account payment procedures within a healthcare organization.

Responsibilities

  • Serve as the primary contact for account questions and requests received by phone, in-person walk-in, email, Epic MyChart, or other websites.
  • Provide patient estimates to uninsured patients and to patients seeking estimates based on their current insurance coverage.
  • Answer inbound calls from patients, physician offices, insurance carriers, and others within the specified response timeframe, aiming to resolve concerns immediately.
  • Respond promptly to patient inquiries about hospital billing procedures, policies, and statements.
  • Use available resources to resolve patient inquiries by phone and when preparing or reviewing billing correspondence.
  • Collect patient payments and follow authorization levels for adjustments, refunds, and contractual allowances.
  • Explain payer regulations and patients’ Explanation of Benefits (EOB).
  • Document account activity clearly, including next steps required for resolution.
  • Prepare written responses regarding account resolution and complaint recovery.
  • Work with administrative departments and hospital service areas to facilitate patient account resolution.
  • Identify barriers to efficient departmental operations and help develop effective solutions.
  • Ensure financial assistance applications are complete and accurate, apply appropriate adjustments, and follow HRH approval-processing guidelines.
  • Work with an on-site state social worker or outside eligibility vendor to assist with Medicaid applications and maximize eligible funding.
  • Help patients develop plans to resolve liabilities, including setting up payment plans according to HRH guidelines.
  • Provide coverage for most departmental positions during vacations or illnesses.
  • Perform other duties as assigned.
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