Patient Access Financial Advocate-ABQ Position Control

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 23,000 - 38,000; Full time

Job summary

Presbyterian Healthcare Services in Albuquerque, NM seeks a Patient Access Financial Advocate to screen and advise patients on financial obligations, insurance eligibility, and available assistance programs. You'll use cost-estimate tools, help set up payment plans, assist with charity care and Medicaid eligibility, and navigate CARES behaviors to deliver excellent patient financial service.

This role supports a broad revenue-cycle process across inpatient, ER and outpatient settings, with a

Qualifications

• Experience in healthcare in a hospital or physician office
• 3–5 years healthcare experience
• Experience in billing office and collections preferred
• Strong customer service and provider/patient interaction
• Knowledge of CARES Behaviors and mission alignment

Responsibilities

• Provide financial screening for scheduled, admitted inpatient and discharged patients in a hospital setting.
• Confirm insurance eligibility and provide benefits review; explain coverage.
• Create and communicate cost estimates for services to patients and other parties.
• Post payments and assist in creating payment plans for services or balances.
• Coordinate and complete financial assistance applications for charity care; Medicaid eligibility determiner.

Skills

Healthcare experience

Billing/collections

Patient interaction

Regulatory knowledge

Education

High school or equivalent

Tools

EPIC proficiency

MS Office

Job description

Location Address:

1100 Central Ave SEAlbuquerque, NM 87106-4930

Compensation Pay Range:

Minimum Offer $16.79Maximum Offer $27.67Now Hiring: Patient Access Financial Advocate-ABQ Position Control

Summary:

Performs financial screening on hospital, Pre-registration, ER and outpatient account, high-deductible plan participants and self-pay patients. Requires thorough knowledge of assistance programs to include Financial Assistance application, Medicaid (PEMOSSA) application and other alternate resource programs in addition to full competency of Presbyterians policy for payment plan application. In depth understanding of benefits administration of PHS contracts and their respective in and out of network arrangements. This role requires comprehension of the pre-billing/pre-adjudication of claim filing to successfully identify out of pocket expense the patient should anticipate. Possess a broad understanding of Presbyterians affiliates and their billing methodologies. Successfully counsel patients and/or families regarding financial responsibilities to Presbyterian. Ability to use standardized procedures that emphasize assertive steps to resolve and gain reimbursement of patient financial obligatory amounts using CARES Behaviors. Ability to research disputed account balances and resolve accounts with outstanding residual balances. Escalates chronic no pay or bad debt accounts to superior. Demonstrates a commitment to Presbyterian s Sense of Mission by role modeling CARES Behaviors and appropriate customer service techniques to perform patient education and act as a resource and advocate to our patients and members.Type of Opportunity: Full timeJob Exempt: NoJob is based: Presbyterian HospitalWork Shift: Days (United States of America)

Responsibilities:

• Provide financial screening to scheduled, admitted inpatient and discharged patients for patients in a hospital setting.
• Responsible for confirming patient insurance eligibility and providing benefits review. Reviews benefits to ensure that organization and patient understand the extent of coverage for services.
• Accurately utilizes cost estimate technology to create cost estimates for services and communicates estimated costs to patients and other affected parties.
• Accurately posts payments and assists in the creation of payment plans for upcoming services and/or outstanding balances.
• Responsible for reviewing account details for patient education and/or correction.
• a.Reviews balances and communicates to patient and other affected parties about outstanding balances.
• b.Assists patients in resolving account questions and concerns.
• c.Responsible for coordinating and completing financial assistance application for charity care program.
• Will be Medicaid eligibility determiner
• a.EMSA,
• b.Baby BOT registrar
• c.Institutional Medicaid
• Insurance certified enrollment counselors for the Healthcare Exchange
• Handle walk in billing and Albuquerque Ambulance billing question.
• Work with Medicare patients that have an open MSP.
• Screen all Indian Health patients.
• Responsible for understanding the revenue cycle, including all involved parties and appropriate escalation pathways.
• Knowledge of various regulatory agencies: JCAHO, Medicare/Medicaid Laws, State & Federal Laws, Hospital/Departmental Policies.
• Duties performed may include one or more of the following core functions: a) Directly interacting with or caring for patients; b) Directly interacting with or caring for human-subjects research participants; c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
• Performs other duties as assigned.

Qualifications:

• Academic Preparation:
• *High school or equivalent
• Experience:
• *Three to five years of healthcare experience in a physician office or hospital setting
• *Prior billing office and collection experience preferred

Qualifications:

• *Significant provider and patient interaction experience

Qualifications:

• Abilities:
• *Demonstrates a commitment to Presbyterians Sense of Mission by role modeling CARES Behaviors and appropriate customer service techniques to perform patient education and act as a resource and advocate to our patients and members
• *Requires detailed knowledge of operations in a medical practice in terms of what and how work is to be done as well as why it is done
• *Familiarity with the Affordable Care Act and healthcare s role in assisting patients and patients families with health care costs
• *Must be able to interpret data
• *Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope.
• *Demonstrated strong keyboarding skills, ensuring efficient data entry and documentation.
• *Knowledge in Microsoft Office Products.
• *Pass EPIC proficiency test required with a 85% score at completion of the Epic Training class.
• Candidates must be at least 18 years of age at the time of hire

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services