Financial Advocate

Role Overview

• Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service
• Communicates patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments and how they may affect the cost of care
• Explains how non-covered and out-of-network services factor into the out-of-pocket cost
• Requests upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances
• Establishes payment arrangements in advance of scheduled services when applicable, communicating due dates and the amount of each installment
• Interviews uninsured patients to assess for qualifying financial needs
• Identifies available assistance programs and coordinates with patient to complete paperwork and applications for any potential coverage(s)
• Continues follow-up efforts to obtain a funding source for patient’s health services
• Initiates credit scoring to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs through a comprehensive patient interview
• Works in conjunction with state social worker and/or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility
• Stays current on regulations and eligibility requirements for government funding, especially Medicare and Medicaid
• Collaborates with peers in the operational flow for uninsured patients or patients that are concerned about costs for upcoming services

Requirements

• High School Graduate, or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)
• Typically requires 2 years of experience in Patient Access, health care, insurance industry, or in a customer service setting
• Solid knowledge of how various types of insurances operate related to denials and appeals processes
• Basic medical coding knowledge
• Understanding of insurances, billing and denials
• Ability to use a combination of scripted notes and clear, written communication when documenting in patients’ accounts

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short
• and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program