Patient Financial Solutions Specialist

Advocate Health Care; Libertyville (IL); On-site; USD 42,000 - 62,000; Full time

Job summary

Advocate Health Care seeks a Financial Advocate to determine patient financial responsibility and communicate options before services. The role involves educating patients on deductibles, coinsurance, copayments, and out-of-pocket costs, while coordinating with insurance and charity programs.

Responsibilities include arranging upfront payments, assisting with Medicaid applications, and ensuring HIPAA compliance in all interviews and documentation.

Qualifications

• Ability to communicate clearly and proactively to management about customer service and process improvement opportunities.
• Ability to articulate explanations of HIPAA and EMTALA regulations as they relate to patient interactions within the workflow.
• 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.
• Ability to document in patients’ accounts with clear notes.

Responsibilities

• Calculate and provide patients with personalized estimates of their financial responsibility based on insurance prior to service.
• Explain patient liability clearly and accurately, including deductibles, coinsurance, and copayments, and impact of non-covered/out-of-network services.
• Request upfront payment toward self-pay amounts and establish payment arrangements ahead of scheduled services.
• Interview uninsured patients to assess financial needs and identify assistance programs or coverage options.
• Initiate credit scoring to determine eligibility for Medicaid, charity care, and other programs.
• Collaborate with state social workers or vendors to assist Medicaid applications and maximize funding.
• Educate patients and physician offices on Financial Assistance Policy and related processes.
• Stay current on government funding regulations (Medicare/Medicaid) and internal charity care policies.
• Collaborate with peers to support uninsured patients across various settings.

Skills

Communication

HIPAA/EMTALA explanations

Insurance benefits knowledge

Medical coding knowledge

Customer service

Documentation clarity

Education

High School Diploma or GED/HSED

Tools

None

Job description

Advocate Health Care seeks a Financial Advocate to determine patient financial responsibility and communicate options before services. The role involves educating patients on deductibles, coinsurance, copayments, and out-of-pocket costs, while coordinating with insurance and charity programs.

Responsibilities include arranging upfront payments, assisting with Medicaid applications, and ensuring HIPAA compliance in all interviews and documentation.