Patient Financial Advocate-Pan American Family Practice

Overview

Presbyterian is seeking a Patient Financial Advocate-Pan American Family Practice 

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 Community Benefit Application, Medicaid (PEMOSSA) application where applicable and other alternate resource programs in addition to full competency of Presbyterian policy for payment plan application. Research disputed account balances and resolve accounts with outstanding residual balances. Must possess in depth understanding of benefits administration of PHS contracts and their respective in and out of network arrangements. Comprehension 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 Presbyterian. Escalates 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

We're determined to take care of those working in healthcare.

Presbyterian is dedicated to improving people's lives - the lives of our patients and the lives of our coworkers. We're locally owned and operated, which encourages supportive leadership that emplowers employees. And we provide the opportunity to gorw from entry-level to the most senior positions.

Why Join Us

• Full Time - Exempt: No
• Job is based at Presbyterian Northside
• Work hours: Weekday Schedule Monday-Friday
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Ideal Candidate: Three to five years of healthcare experience in a physician office or hospital setting. Prior billing office and collection experience preferred

Qualifications

• Academic Preparation: High school or equivalent
• Experience:
• Three to five years of healthcare experience in a physician office or hospital setting
• Prior billing office and collection experience preferred
• Significant provider and patient interaction experienceAbilities:
• Demonstrates 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 members
• Requires 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 done
• Familiarity with the Affordable Care Act and healthcare s role in assisting patients and patients families with health care costs
• Must be able to interpret data
• Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope

Responsibilities

Customer Service and Caring Practices:

• 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 times
• Ability to manage conflict and appropriately request the help of a supervisor when appropriateEncounter Components:
•  Calculate 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 patients
•  In one on one patient interactions set expectation for payment when applicable
• Set up payment plans in Epic per guidelines
•  Registration accuracy skills to insure correct coordination of
• 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 considerationFinancial Accountabilities:
• Collects identified patient financial obligation amounts including residual balance if applicable
•  In one on one patient interactions set expectation for payment when applicable
•  Refers as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center
•  Follows PMG cash handling policies and balances daily
•  Keeps current on PHS financial policies, including payment plans