UMH Sparrow - PATIENT FINANCIAL ADVOCATE

Peoplefluent; Lansing (MI); Hybrid; USD 52,000 - 76,000; Full time

Job summary

University of Michigan Health Sparrow is seeking a Patient Financial Advocate to support patients facing unexpected medical bills and insurance gaps. The role involves analyzing cases, performing data-driven reviews, and coordinating with management to implement best practices.

The position focuses on resolving complex billing issues, guiding patients through insurance options, and partnering with community programs to improve enrollment and financial outcomes for patients across Sparrow

Qualifications

• Bachelor’s degree in Business Administration or Health Care Administration or related field with 2+ years as patient financial counselor.
• Alternative: Associate degree with 4+ years in patient financial counseling and billing/revenue cycle.
• High School diploma with 6+ years in patient financial counseling in healthcare revenue cycle.

Responsibilities

• Advocate for patients facing complex financial obligations and insurance gaps.
• Resolve escalated billing and authorization issues using best practices.
• Educate patients on plans, networks, and enrollment options.
• Monitor financial status of patients with complex cases and coordinate with payers and attorneys.
• Collaborate with Sparrow community programs to reduce uninsured rates.

Skills

Project management

Meet deadlines

Communication

De-escalation

Teamwork

Research & analysis

Education

Bachelor's degree in Business Administration or Health Care Administration

Associates degree in business or related field

High School Diploma with relevant experience

Tools

Epic EHR

Visio

Revenue Cycle systems

Job description

UMH Sparrow - PATIENT FINANCIAL ADVOCATE

Job ID: 56077

Positions Location: Lansing, MI

Job Description

General Purpose

Under the general supervision of the Director Patient Access the Patient Financial Advocate will define and implement best practices to support patients experiencing unexpected financial obligations and/or loss of insurance coverage. The Patient Financial Advocate will use fact-finding combined with data analysis, case reviews, auditing, gap analysis, and published industry best practices to streamline work, and close identified gaps. Effectively communicate solutions, issues, and risks directly with management or other responsible entities to ensure a fully integrated solution across multiple work streams.

Essential Duties

• Perform patient financial advocacy, business analysis, process evaluation, design and documentation duties primarily related to creating the ideal patient financial experience.
• Serves as a patient advocate by resolving complicated escalated billing, financial counseling, and authorization related issues and integrate solutions into best practices, using outstanding and proven customer service skills with the ability to successfully de-escalate sensitive patient calls.
• Is personally responsible for patients and families who require ongoing complex financial care for the duration of those patients’ medical care at Michigan Medicine and the processes that impact the patients.
• Monitors and proactively manage the financial status of patients with very complex financial constructs, communicating with internal and external customers, i.e. the patients, families, attorneys, assistance programs, insurance companies needed to make sure that they have the best financial experience possible.
• Works closely with leaders and organizations to help serve Sparrow communities, including the UMH Sparrow rural health clinics and programs.
• Participate in all UMH Sparrow sponsored community events.
• Works directly with the communities and other organizations to decrease Ingham, Eaton, Clinton, Montcalm, Gratiot, Ionia, and Shiawassee counties uninsured rates by educating patients on the importance of health insurance, various plans and networks along with increasing Marketplace and Medicaid insurance enrollment.
• Community outreach includes participating in community and other organized events, presenting to target audiences, and connecting with underserved populations within the community (example: community fair, presentation to civic groups, health fairs etc.)
• Serve on standing community organizations and outreach programs to form mutually beneficial partnerships (example: Lansing – Cristo Rey Community Health Center & Care Free Clinic, and like organizations within our broad service area)
• Enroll patients in ACA and Medicaid plans and work closely with DHHS workers on pending applications.
• Provide necessary education and training to staff on tools and resources to support the financial success of the Pre-Service division.
• Partner with vendors, payers, internal customers, and peer organizations to achieve optimum performance of technology and processes.
• Participate in KPI and Metrics reporting collection, presentation, and other community connection documentation needed for non-profit, government regulatory, or other community outreach reporting.
• Analyze business and user needs, documenting requirements and revising existing system or process difficulties.
• Analyze, compare and evaluate various courses of action.
• Competence in applicable phases of systems analysis and considers the business implications of the application of technology to the current business environment.
• Perform other related duties as assigned. Opportunities may exist to work on other departmental projects based on current workload and needs.

Job Requirements

Work Experience

• Experience dealing with payers and government agencies regarding process issues that result in non-payment of beneficiaries’ medical charges.
• Experience with vendor and customer relationship management, preferred.
• Familiarity with diverse operating environments, applications and equipment, preferred.
• Experience with the Epic health information system, preferred.
• Experience in medical accounts receivable and billing, preferred.
• Experience with and understanding of Michigan Medicine’s multiple business systems that drive Revenue Cycle, preferred.

Education

Education A Bachelor’s degree in Business Administration, Health Care Administration or related field and a minimum of 2 years as a patient financial counselor with a proven record of assisting patients with complex medical billing issues and a minimum of 2 years billing and/or claims experience in Revenue Cycle or healthcare setting with progressive levels of responsibility or completion of an accredited billing and claims processing program (college or technical education or combination thereofORAn Associates degree in business or related field and a minimum of 4 years as a patient financial counselor with a proven record of assisting patients with complex medical billing issues and a minimum of 4 years billing and/or claims experience in Revenue Cycle or healthcare setting with progressive levels of responsibility or completion of an accredited billing and claims processing program (college or technical education or combination thereof.ORA high school diploma and a minimum of 6 years as a patient financial counselor with a proven record of assisting patients with complex medical billing issues and a minimum of 6 years billing and/or claims experience in Revenue Cycle or healthcare setting with progressive levels of responsibility or completion of an accredited billing and claims processing program (college or technical education or combination thereof)

Specialized Knowledge and Skills

• Ability to manage small/medium projects, multi-task medium to complex work assignments, and meet critical deadlines.
• The ability to lead meetings, take minutes, track key decision points, prioritize deliverables, and maintain issues lists.
• Demonstrated ability to probe for information about the underlying needs of the patient, organization, and user community, which directly influences how the process of system will be revised, built, or managed.
• Demonstrated ability to perform business analysis and workflow documentation including appropriate tools such as the use and knowledge of Visio (or equivalent workflow software).
• Ability to troubleshoot and resolve problems, provide user support, create reports, and communicate to management.
• Organized, detail oriented with strong communication, planning and follow-up skills.
• Proactive team-oriented work style with critical thinking and problem-solving abilities.
• Excellent interpersonal, written, and oral communication, organizational and customer-service skills, professional image, confidence in dealing with complex business situations, ability to successfully de-escalate sensitive patient calls.
• Demonstrated ability to present to large and small groups to promote community education.
• Communicates effectively at all levels of an organization with the ability to work within and across teams on Revenue Cycle issues.
• Demonstrates high level of commitment and integrity. Ability to maintain a positive attitude while working in a dynamic, fast-paced environment.
• Knowledge of medical terminology, ICD-10, CPT-4, and CDM codes, coding principals and their application to billing.
• Extensive knowledge of clinical business operation systems. Knowledge of Snap, Web Denis, CHAMPS and other payor sites. In depth knowledge of 3rd party payer rules (Medicare, Medicaid, BCBSM, commercial, MVA, workers compensation).
• Excellent record of attendance and punctuality.

University of Michigan Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

Job Family

Patient Services/Nursing Support

Requirements:

Shift Days Degree Type / Education Level High School / GED Status Full-time Facility Sparrow Hospital Experience Level New Grad