Patient Access Financial Advocate

NOW HIRING A PATIENT FINANCIAL ADVOCATE-Admitting

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.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

 

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time - Exempt: No
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• 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

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. 

• Provide financial screening to scheduled, admitted inpatient and discharged patients for patients in a hospital setting.
  Responsible for confirming patient insurance eligibility and providing benefits review. Reviews benefits to ensure that organization and patient understand the extent of coverage for services.
• Accurately utilizes cost estimate technology to create cost estimates for services and communicates estimated costs to patients and other affected parties.
• Accurately posts payments and assists in the creation of payment plans for upcoming services and/or outstanding balances.Responsible for reviewing account details for patient education and/or correction.
  a. Reviews balances and communicates to patient and other affected parties about outstanding balances.
  b. Assists patients in resolving account questions and concerns.
  c. Responsible for coordinating and completing financial assistance application for charity care program.
  Will be Medicaid eligibility determiner
  a. EMSA,
  b. Baby BOT registrar
  c. Institutional Medicaid
• Insurance certified enrollment counselors for the Healthcare Exchange
• Handle walk in billing and Albuquerque Ambulance billing question.
  Work with Medicare patients that have an open MSP.
  Screen all Indian Health patients.
• Responsible for understanding the revenue cycle, including all involved parties and appropriate escalation pathways.
  Knowledge of various regulatory agencies: JCAHO,
• Medicare/Medicaid Laws, State & Federal Laws, Hospital/Departmental Policies.
• Duties performed may include one or more of the following core functions: a) Directly interacting with or caring for patients; b)
• Directly interacting with or caring for human-subjects research participants; c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
  Performs other duties as assigned.

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 improve the health of patients, members, and the communities we serve. We are 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 - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

NCS#123

USD $23.07/Hr.

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.