Patient Financial Advocate

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

Benefits offered by this job

Comprehensive benefits package

Job summary

Presbyterian Healthcare Services is seeking a Patient Financial Advocate in Albuquerque to perform financial screening and identify residual balances for hospital and medical group accounts. You will counsel patients on financial responsibilities and navigate assistance programs, including Medicaid and marketplace options.

You will coordinate with the Financial Advocacy Center for uninsured patients, set up payment plans in Epic, and document all discussions and outcomes.

Qualifications

• High school or equivalent
• 3–5 years of healthcare experience in a physician office or hospital setting
• Experience in billing/collections preferred
• Familiarity with the Affordable Care Act and healthcare cost assistance programs

Responsibilities

• Perform financial screening to identify residual balances and self-pay patients
• Set up payment plans in Epic per guidelines
• Document patient discussions and outcomes in guarantor accounts
• Refer uninsured patients to the Financial Advocacy Center
• Follow PMG cash handling policies and maintain accurate records

Skills

Healthcare experience

Customer service

Communication skills

Problem solving

Education

High school diploma or equivalent

Tools

Epic

Job description

Location Address:5550 Wyoming Blvd NE Albuquerque, NM 87109-3167Compensation Pay Range:Minimum Offer $16.79 Maximum Offer $27.67 Now Hiring: Patient Financial AdvocateSummary:Performs financial screening on hospital and medical group account activity to identify residual balances, high-deductible plan participants and self-pay patientsRequires thorough knowledge of assistance programs to include Community Benefit Application, Medicaid (PEMOSSA) application where applicable and other alternate resource programs in addition to full competency of Presbyterian policy for payment plan applicationResearch disputed account balances and resolve accounts with outstanding residual balancesMust possess in depth understanding of benefits administration of PHS contracts and their respective in and out of network arrangementsComprehension of the pre-billing/pre-adjudication of claim filing to successfully identify out of pocket expense to counsel patient and/or families regarding financial responsibilities to PresbyterianEscalates chronic no pay or bad debt accounts to supervisorRefers patients without insurance coverage to the Financial Advocacy Center located at Main PHS for navigation of options to manage healthcare costs, including using the Market Place for obtaining health insurance coverageOther duties as assigned Type of Opportunity: Full time Job Exempt: No Job is based: PMG - Wyoming Work Shift: Days (United States of America)Responsibilities:Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.Addresses and attempts to appropriately resolve complaints in the moment by using key words at key timesAbility to manage conflict and appropriately request the help of a supervisor when appropriateCalculate patient out of pocket expenses (copayment, coinsurance, residual, deductible etc.)Use workflow to adjust the DAR (Epic Dept Appointment Report) to alert registration staff of residual amounts for appointed patientsIn one on one patient interactions set expectation for payment when applicableSet up payment plans in Epic per guidelinesRegistration accuracy skills to insure correct coordination ofExceptional registration accuracy skills to identify errors and correct them as necessary. Serves as a resource to staff regarding account interpretations. Identify claims where filing errors have occurred and resubmit the claims to payors for considerationCollects identified patient financial obligation amounts including residual balance if applicableIn one on one patient interactions set expectation for payment when applicableRefers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy CenterFollows PMG cash handling policies and balances dailyKeeps current on PHS financial policies, including payment plans, programs and other forms of fundingDocuments patient discussion, agreed upon outcomes and audit trail note in guarantor account notes or the auth/cert screen as applicable.Comprehend quality service connection to patient satisfaction and reimbursementRespond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist in any manner the clinic team directs.Ensure registration area, waiting area and walkways are clear of any unnecessary items and are clean and neat.Report any concern that may create a safety issue.Annual competency completion of Clerical Staff during a Code BlueQualifications:High school or equivalentExperience:Three to five years of healthcare experience in a physician office or hospital settingPrior billing office and collection experience preferredSignificant provider and patient interaction experienceDemonstrates 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 membersRequires 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 doneFamiliarity with the Affordable Care Act and healthcare s role in assisting patients and patients families with health care costsMust be able to interpret dataComprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scopeCandidates must be at least 18 years of age at the time of hireAll 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.WellnessPresbyterian'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 ServicesPresbyterian 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