Patient Advocate Jobs

About The Position

Requirements

• High school diploma or GED.
• At least one year of work experience in Patient Access and/or billing, plus a strong customer-service background.
• Completion and passing of the Patient Access Advocate II Advancement test after meeting experience guidelines.
• Strong understanding of insurance and financial account processing.
• Basic understanding of medical terminology and billing codes, including DRG, ICD-10, CPT, and HCPCS.
• Proficiency with the EPIC ADT system.
• General knowledge of the customer encounter process, which may include registration, healthcare practices, financial guidelines, and coordination of benefits.
• Ability to work independently and in a self-directed manner, including with individuals from diverse backgrounds.
• Effective communication skills.
• Analytical and problem-solving skills.
• Knowledge of Microsoft Office products.
• Completion of, or enrollment in, the two-week Patient Access Academy with a passing score of at least 85%.
• Pass the EPIC proficiency test with a score of at least 85% upon completion of the Epic Training class.
• Demonstrated strong keyboarding skills for efficient data entry and documentation.
• Pass annual competency examinations for all areas of responsibility.
• Be at least 18 years old at the time of hire.

Nice To Haves

• CHAA, CHAM, or another industry-equivalent certification.

Responsibilities

• Provide an exceptional experience to patients and families using CARES, AIDET, EPE, and PROMISE behaviors.
• Address and attempt to resolve complaints using de-escalation processes, and involve a supervisor when needed.
• Explain insurance benefits and liabilities to patients and help address concerns about hospital financial matters.
• Register patients and accurately obtain, confirm, enter, and update demographic and financial information.
• Review urgent and emergent admission accounts for notification requirements.
• Obtain missing insurance information and verify eligibility and benefits through electronic systems or directly with payers.
• Review accounts and work queues to confirm accurate policy, group, subscriber, authorization, payer, and coordination-of-benefits information.
• Document actions accurately in the system of record and maintain complete, timely records and an effective audit trail.
• Maintain knowledge of authorization requirements, payer guidelines, Medicare (CMS) guidelines, admissions forms, benefit-entitlement verification, and billing requirements.
• Complete the Medicare Secondary Payer Questionnaire (MSPQ) at the time of service when it was not completed during financial clearance.
• Meet productivity standards and recommend ways to improve performance and productivity.
• Monitor and track the Data Quality program and correct errors at the time of service.
• Collect identified patient financial obligations, including residual balances when applicable, and communicate liabilities transparently.
• Educate patients about financial assistance, charity, and other available programs, and refer them to a Financial Advocate or the Financial Advocacy Center as appropriate.
• Complete missing account information to ensure accuracy at the time of the visit.
• Cooperate with risk-management activities and investigations; promptly report suspected or potential violations and cooperate with related investigations.
• Conduct transactions in compliance with company policies, procedures, standards, practices, and applicable legal and regulatory requirements.
• Provide wayfinding assistance to patients and visitors and provide coverage in other areas as needed.
• Attend staff meetings and employee forums, and pass annual competency examinations for all areas of responsibility.
• Perform other duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Short-term disability insurance
• Long-term disability insurance
• Group term life insurance
• Other optional voluntary benefits
• Employee Wellness rewards program offering opportunities to earn gift cards and other rewards through wellness activities