Financial Advocate
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Job Description
Financial Advocate assisting patients with understanding their financial responsibilities based on insurance coverage. Communicating payment options and establishing arrangements for health services.
Responsibilities:
- Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service
- Communicates patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments and how they may affect the cost of care
- Explains how non-covered and out-of-network services factor into the out-of-pocket cost
- Requests upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances
- Establishes payment arrangements in advance of scheduled services when applicable, communicating due dates and the amount of each installment
- Interviews uninsured patients to assess for qualifying financial needs
- Identifies available assistance programs and coordinates with patient to complete paperwork and applications for any potential coverage(s)
- Continues follow-up efforts to obtain a funding source for patient’s health services
- Initiates credit scoring to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs through a comprehensive patient interview
- Works in conjunction with state social worker and/or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility
- Stays current on regulations and eligibility requirements for government funding, especially Medicare and Medicaid
- Collaborates with peers in the operational flow for uninsured patients or patients that are concerned about costs for upcoming services
Requirements:
- High School Graduate, or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)
- Typically requires 2 years of experience in Patient Access, health care, insurance industry, or in a customer service setting
- 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 use a combination of scripted notes and clear, written communication when documenting in patients’ accounts
Benefits:
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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