Patient Financial Advocate

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

Job summary

Presbyterian Healthcare Services in Santa Fe, NM is hiring a Patient Financial Advocate to screen hospital and medical group accounts for residual balances and high-deductible patients, guiding patients to available assistance programs and payment plans. The role emphasizes patient counseling, adherence to Presbyterian policies, and proactive communication with clinic leadership.

The candidate will work within Presbyterian Santa Fe Medical Center, handling pre-billing considerations and

Qualifications

• 3–5 years of experience in healthcare with significant patient interaction.
• Physician office or hospital experience preferred.
• Prior billing office and collection experience preferred.
• Must be able to demonstrate Epic competencies within 30 days of hire.
• Candidates must be at least 18 years of age at the time of hire.

Responsibilities

• Calculate patient out-of-pocket expectations (co-insurance, co-payment, deductible, residuals) and discuss with patient prior to visit.
• Achieve successful collection rate of residual, high-deductible and self-pay amounts using CARES Behaviors.
• Maintain registration accuracy and correct errors; assist staff with account interpretation.
• Research disputed balances and resubmit claims to payors as needed.
• Provide patient estimator tools to offer reasonably accurate out-of-pocket estimates to patients and guarantors.
• Support clinic/hospital operations by assisting clerical staff with patient account discussions and escalations.

Job description

Location Address

4801 Beckner RoadSanta Fe, NM 87507

Compensation Pay Range

Minimum Offer $16.79Maximum Offer $27.67Now Hiring: Patient Financial Advocate

Job Details

Type of Opportunity: Full timeJob Exempt: NoJob is based: Presbyterian Santa Fe Medical CenterWork Shift: Days (United States of America)

Summary

Performs financial screening on hospital and medical group account activity to identify residual balances, high-deductible plan participants and self-pay patients. Requires thorough knowledge of assistance programs to include charity care 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 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.

Responsibilities

• Calculate patient out of pocket expectation (co-insurance, co-payment, deductible, residual amounts) and alert patient to that balance prior to upcoming visit. Use coding knowledge to calculate charges for more complicated levels of service (modifiers, lesions, etc). Contact patient to set the expectation for payment during the visit. Offer an appointment to review account when questions exist.
• Successful collection rate of residual, high-deductible and self pay amounts in a courteous, professional manner using CARES Behaviors.
• Exceptional 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 consideration.
• Demonstrated competence in using patient estimator technology and on line tools available to provide a reasonably accurate out of pocket expense expectation for patients and their guarantors.
• Facilitates the operations of the clinic or hospital by providing support to clerical staff to discuss account activity with patients and guarantors. Communicates appropriate situations to Clinic Manager , DPO, and Patient Access Supervisor.
• Keeps current on PHS financial policies, including payment plans, programs and other forms of funding.
• Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope.
• Responsible for covering other POB/PMG clerical operations duties based on business need
• Other duties as assigned.

Qualifications

• Three to five years of experience in healthcare field with significant MD and patient interaction required.
• Physician office or hospital experience preferred.
• Prior billing office and collection experience preferred.
• Must be able to demonstrate competency in registration with the ability to pass all Epic competencies within 30 days of hire
• 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