Supv Patient Financial Services and Advocacy

Fairview Health Services•Shoreview, MN

1d•Remote

About The Position

The Supervisor, Patient Financial Services and Advocacy leads a team of patient advocates, and customer service specialists within the home infusion business office. This role serves as the frontline management authority responsible for ensuring patients receive compassionate, knowledgeable, and solution-oriented financial guidance throughout the home infusion therapy lifecycle. The Supervisor drives operational excellence in billing dispute resolution, patient account problem-solving, and financial assistance coordination while maintaining the highest standards of empathy and professionalism. This individual must possess deep fluency in the unique challenges of home infusion billing and reimbursement or demonstrate extensive, proven expertise in high-touch customer service environments where de-escalation, dispute resolution, and emotionally intelligent communication are essential daily requirements. They must be a skilled communicator who can navigate difficult financial conversations with patients and families during stressful medical situations, coach team members to do the same, and foster a culture of advocacy and accountability. This is a remote role from Monday-Friday 8:00AM-4:30PM

Requirements

Bachelor of Arts Healthcare Administration, Business, Finance or equivalent area or OR an equivalent combination of education, certification, and directly relevant experience may be considered in lieu of a degree
5 years Progressive experience in patient financial services, healthcare revenue cycle, patient access or medical billing/collections
2 years Supervisory, lead, or people management role directly overseeing a team of 5 or more staff.
5 years Demonstrated hands-on experience in one or more of the following areas: a) Home infusion, specialty pharmacy, or infusion center billing and reimbursement, including familiarity with J-codes, per diem billing, drug reimbursement models, and PBM vs. medical benefit adjudication; OR b) Extensive experience (5+ years) in a high-volume, high-touch customer service, patient advocacy, or financial counseling environment with documented proficiency in conflict resolution, complaint management, and de-escalation of emotionally charged interactions
Strong working knowledge of commercial insurance, Medicare, Medicaid, and pharmacy benefit structures as they relate to home infusion services
Proficiency in healthcare billing systems (e.g. - Epic, Brightree, CareTend, CPR+, or equivalent home infusion pharmacy management systems)
Familiarity with HCPCS, CPT, ICD-10 coding relevant to infusion therapies
Knowledge of the No Surprises Act, HIPPA, FDCPA, and state-specific balance billing and collections regulations
Proficient in Microsoft Office Suite (Excel, Word, Outlook, Teams) and experience with CRM or case management platforms

Nice To Haves

Certified Revenue Cycle Representative (CRCR), Certified Patient Account Representative (CPAR), or Certified Healthcare Financial Professional (CHFP)
Formal training or certification in conflict resolution, mediation, crisis communication, or similar disciplines (e.g., CPI, de-escalation certification)
3 years Proven track record of successfully resolving complex billing disputes, patient grievances, and escalated financial complaints with positive outcomes
3 years Experience developing and delivering staff training programs focused on communication skills, customer service excellence, and dispute resolution

Responsibilities

Directly supervise, mentor, and develop a team of 4-8 Billing Specialists, Financial Advocates, and Customer Service Representatives.
Conduct regular one-on-one coaching sessions focused on communication skills, de-escalation techniques, empathy-driven service, and professional development goals.
Lead daily and weekly team huddles to review escalated cases, share best practices, communicate policy changes, and maintain team morale.
Manage scheduling, workload distribution, and staffing coverage to ensure consistent service levels across all patient financial touchpoints.
Perform ongoing performance evaluations, create individual development plans, and administer corrective action when necessary in accordance with HR policies.
Recruit, interview, hire, and onboard new team members; design and deliver training programs specific to home infusion financial services, patient communication, and dispute resolution.
Foster a positive, supportive team culture where staff feel empowered to advocate for patients while maintaining fiscal responsibility.
Serve as the senior point of escalation for complex, sensitive, or high-conflict patient financial inquiries, complaints, and disputes.
Personally handle the most challenging patient interactions, including emotionally charged conversations around high-balance accounts, denied claims, unexpected out-of-pocket costs, collections activity, and payment disputes.
Employ advanced de-escalation techniques including active listening, empathetic acknowledgment, solution-focused questioning, and calm redirection to resolve conflicts and reach mutually acceptable outcomes.
Investigate and resolve formal patient grievances and complaints related to billing, collections, financial assistance determinations, and service failures within established turnaround times.
Develop and maintain standardized scripts, talk tracks, and response frameworks for common dispute scenarios specific to home infusion services (e.g., drug cost disputes, authorization denials, coordination of benefits issues, out-of-network disputes).
Track escalation patterns, identify root causes of recurring disputes, and implement proactive process improvements to reduce complaint volume.
Collaborate with clinical staff, pharmacy team, and case management to ensure patients receive transparent, accurate financial information before and during treatment.
Align with the patient financial services process from initial benefit verification through treatment completion, ensuring patients understand their financial responsibilities, coverage details, co-pay/co-insurance obligations, and available assistance options.
Supervise the screening and enrollment process for manufacturer patient assistance programs (PAPs), copay assistance cards, foundation grants, health system charity care, Medicaid presumptive eligibility, and other financial hardship programs.
Ensure team members understand the estimated patient out-of-pocket costs, present Good Faith Estimates in compliance with the No Surprises Act and document all financial counseling interactions.
Serve as a liaison between patients, insurance companies, pharmacy benefit managers (PBMs), and clinical teams to advocate for coverage of prescribed home infusion therapies.
Review and approve financial hardship applications, payment plan arrangements, and account adjustments within established authority limits.
Ensure new copay assistance and patient assistance payers are set up appropriately in Epic.
Ensure departmental compliance with HIPAA, the No Surprises Act, state balance billing regulations, Fair Debt Collection Practices Act (FDCPA), and all applicable healthcare financial regulations.
Conduct regular quality audits of patient financial interactions (calls, written correspondence, in-person counseling) and provide actionable coaching feedback.
Develop, revise, and maintain departmental policies and procedures, standard operating procedures (SOPs), and training materials for all patient financial services functions.
Lead or participate in cross-functional process improvement initiatives aimed at reducing patient financial friction, improving first-call resolution rates, and streamlining authorization workflows.
Serve as a subject matter expert during system implementations, upgrades, or transitions involving billing platforms, patient portals, CRM systems, and phone/IVR technology.
Work with front-end revenue cycle functions including insurance verification, prior authorization, benefits investigation, and predetermination of benefits for home infusion therapies (including specialty drugs, biologics, immunoglobulins, antibiotics, TPN, chemotherapy, and hydration therapy).
Understand team workflows related to claim submission, denial management, appeals, and accounts receivable follow-up specific to home infusion payer requirements.
Ensure compliance with CMS, state Medicaid, commercial and copay program billing guidelines for home infusion services, including HCPCS/CPT coding accuracy, medical necessity documentation, and timely filing requirements.
Collaborate with coding and compliance teams to maintain billing accuracy and reduce audit risk.
Work with leaders to monitor and manager key performance indicators (KPIs) including denial rates, days in A/R, collection rates, patient satisfaction scores, call abandonment rates, and escalation volumes; prepare reports and present findings to leadership.