Patient Financial Advocate- HS General Surgery

Overview

Presbyterian is seeking a Patient Financial Advocate- HS General Surgery

 

Performs financial screening on hospital, Pre-registration, ER and outpatient account, high-deductible plan participants and self-pay patients. Requires thorough knowledge of assistance programs to include Financial Assistance 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 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.

 

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 empowers 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 Hospital
• 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

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 experience
• Abilities:
• 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 scop. 

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 appropriate
•  

Encounter 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 consideration

Financial 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, programs and other forms of funding

Medical Record Components:

 

• Documents patient discussion, agreed upon outcomes and audit trail note in guarantor account notes or the auth/cert screen as applicable. Patient Relations
•  Comprehend quality service connection to patient satisfaction and reimbursement Patient Safety
•  Respond quickly to patients showing distress. Follow guidelines set forth by the Clinic Manger to alert the clinical team. Assist in any manner the clinic team directs.
•  Ensure registration area, waiting area and walkways are clear of any unnecessary items and are clean and neat.
•  Report any concern that may create a safety issue.
•  Annual competency completion of Clerical Staff during a Code BlueC.A.R.E.S Behaviors:
• Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounterProfessional Requirements:
•  Pass annual competency exam for all areas of responsibility.
•  Attend Quarterly MSO meetings.
•  Attend Staff meetings
•  Attend Employee Forums

Benefits

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 ensure the patients, members and communities we serve can achieve their best health. We are a 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.

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.

Maximum Offer for this position is up to

USD $23.76/Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.