Healthcare Financial Navigator

Advocate Health; Charlotte (NC); Sur place; USD 32 000 - 47 000; Plein temps

Avantages offerts par ce poste

Health and welfare benefits

Paid Time Off

Educational Assistance Program

Retirement plan with employer match

Résumé du poste

Advocate Health in Charlotte, NC seeks a Financial Advocate to calculate patient liability, communicate cost estimates, and initiate funding conversations before services. The role guides uninsured patients through potential coverage options and uses credit scoring to assess Medicaid/charity eligibility, coordinating with state workers as needed.

The position requires HIPAA knowledge, understanding of insurance denials, and the ability to explain complex billing concepts to patients and

Qualifications

• Typically requires 2 years of experience in Patient Access, health care, insurance industry, or in a customer service setting.
• Ability to communicate clearly and proactively to management about issues involving customer service and process improvement opportunities.
• Ability to articulate explanations of HIPAA and EMTALA regulations as they relate to all patient interactions within the operational flow involving the Financial Advocate.
• Has 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

Responsabilités

• 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.
• Requests upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances.
• Interviews uninsured patients to assess for qualifying financial needs and coordinates with patient to complete paperwork and applications for any potential coverage(s).
• 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.
• Demonstrates working knowledge of insurance benefits, insurance companies, and Marketplace insurance options, and stays informed of other payer sources entering the markets.
• Educates physician office/patient on the organization’s applicable policies such as Financial Assistance Policy, Patient Financial Responsibility, Non-Covered Services, and Deferral of Care.
• Stays current on regulations and eligibility requirements for government funding, especially Medicare and Medicaid. Understands and complies with all internal charity care policies and processes. Understands, complies with, and can articulate federal regulations around 501R.
• Collaborates with peers in the operational flow for uninsured patients or patients that are concerned about costs for upcoming services.

Connaissances

Clear communication

HIPAA/EMTALA explanations

Insurance knowledge

Medical coding knowledge

Billing/denials understanding

Documentation skills

Formation

High school diploma or GED/HSED

General Educational Development equivalent

Description du poste

Advocate Health in Charlotte, NC seeks a Financial Advocate to calculate patient liability, communicate cost estimates, and initiate funding conversations before services. The role guides uninsured patients through potential coverage options and uses credit scoring to assess Medicaid/charity eligibility, coordinating with state workers as needed.

The position requires HIPAA knowledge, understanding of insurance denials, and the ability to explain complex billing concepts to patients and