Pre-Access Advocate

Best Care•Omaha, NE

2d•Onsite

About The Position

Performs a variety of duties as an advocate for clinic patients. Ensures patients are educated on the estimated cost of care and responsible to collecting payments from patients. Performs authorizations in an efficient manner to ensure timely care.

Requirements

High school diploma or General Educational Development (GED) required.
2 years of healthcare experience required, including electronic medical required.
Knowledge of Current Procedural Terminology (CPT) and International Classification of Disease (ICD) codes.
Skill using computers and office equipment.
Skill in organizing and prioritizing work.
Extensive customer contact.
Skilled in time management.
Skilled in oral and written communication.
Ability to work under limited supervision and stressful conditions.
Ability to adhere to all workplace and safety requirements, regulations, standards, and practices.
Ability to travel to rotating work sites.

Nice To Haves

Post-Secondary education in a healthcare field (e.g. CNA, CMA, etc.) preferred.
Registration, insurance, or prior-authorization experience preferred.
OB/GYN office experience preferred.
Knowledge of Insurance billing, payment collection practice and revenue cycle, preferred.

Responsibilities

Serve as an advocate for new patients to Methodist Physicians Clinic.
Creates patient estimates.
Speaks directly with each patient to review estimated cost of care and payment policies.
Assists with FMLA, Disability or other forms in a timely manner.
Verify benefits and obtains authorization using electronic sources to improve efficiency in obtaining authorizations ensuring timely care is provided.
Document medical necessity checking outcome.
Generate waiver / Advanced Beneficiary Notice (ABN) if medical necessity checking does not meet payer criteria, patient is seeking care for a non-covered benefit, or a self-pay patient.
Assists, counsels, and suggests problem solving techniques to patients as they relate to prompt payment of accounts by following department policies to ensure timely resolution of account.
Processes paperwork by reviewing accounts that have filed bankruptcy then forwards to the immediate supervisor for adjustment.
Provides patient assistance when needed regarding resolving billing issues, refund, or collection problems, insurance questions including Medicare/Medicaid by following established policies for account resolution and patient satisfaction.
Assists patients with community resources when needed.
Works with drug companies when needed to secure financial assistance for patients.
Assists patients with Every Women Matters.
Manages patient accounts.
Responsible for the proper documentation on patient accounts regarding financial arrangements, insurance coverage, special instructions from physicians, and other pertinent information needed to ensure proper handling of the account.
Verifies insurance or determine if self-pay.
Set up account and payment plans.
Monitors payments.
Complete work associated with insurance change during.
Responsible for the daily deposit and daily return mail.
Open safe in am and distribute bags.
Secure bags at end of day in safe.
Prepare daily deposit for pick up.
Reviews daily return mail by checking status of accounts on computer and determines any action to be taken using appropriate skip tracing techniques to facilitate timely billing of patients.
Maintains patient confidentiality within the area by following office procedures to ensure all information is correct.
Effectively communicates with other department personnel, nurses, physicians, attorneys, insurance companies, and all other parties, by phone or mail, to maintain professional handling of all situations in relation to patients' accounts.