Patient Financial Advocate - Patient Access

The Patient Financial Advocate (PFA) is responsible for establishing and maintaining a relationship with patients while ensuring that patients who receive services from ProMedica have been properly screened for financial responsibility and are made aware of available avenues for financial assistance and payer sources such as Medicaid & Cobra. The PFA continually supports patients in understanding their financial responsibility, managing patients’ expectations while assisting in establishing payment arrangements, managing referrals for specific patients so authorized services are received, and providing the basis for maximum reimbursement. The PFA is responsible for thorough documentation and account notes, including coordination with other staff who refer patients as well as patients who request financial counseling.

The position is largely patient facing in areas of registration or at bedside, so a substantial focus on customer service is necessary. Contact may also be made with the patient via telephone. The PFA will be bed-side offering in-person financial counseling and education to patients. The PFA ensures proper follow up, documentation, and adherence to ProMedica’s policies and procedures. Given the potentially sensitive nature of these conversations, the PFA needs to prioritize patient experience and patient communication. The PFA must promote an attitude of professionalism at all times and demonstrate model behavior that embodies and reinforces ProMedica’s values and mission to improve the health and well-being of the community.

Scope and Complexity :

The PFA may be responsible for monitoring and controlling daily collection operations to ensure the provision of best practice, customer-focused and cost effective patient financial services for the organization. The PFA may also be responsible for screening patients for eligibility for financial assistance, Medicaid, insurance, COBRA, or any other payer source. Information generally used when solving problems and making decisions in this position can be incomplete, requiring the PFA to research and gather information.

Decisions made by the PFA impact the entire hospital financial operation. Work is guided by defined policies and guidelines, and established practices and plans are subject to strategic guidance and evaluation from senior management. The PFA demonstrates knowledge and skills to appropriately communicate and interact with the patients, families, and visitors of all age groups while being sensitive to their cultural and religious beliefs.

Job Requirements

Education : Associate degree in health or business-related field. Additional experience may substitute for degree.

Skills :

• Broad knowledge of government assistance programs, guidelines and application procedures necessary.
• Must have one to two years of progressively more responsible experience in a hospital registration, billing, and payment processing environment in order to be familiar with internal policies and external third party payer policies and procedures.
• Knowledge of self-pay collections, medical terminology, and a complete understanding of insurance is required.
• Must be able to work independently with little direct supervision.
• Must possess high degree of professionalism, in addition to interpersonal, customer service and communication skills, both verbally and in writing, including knowledge of basic grammar, spelling & punctuation.
• Requires basic math, data entry, 10-key, and keyboarding skills. Ability to type a minimum of 30 words per minute is desired.
• Must be highly organized, detail-oriented, and a self-starter. Requires excellent time management skills, as well as the ability to maintain confidentiality standards.
• Must be able to demonstrate interviewing and investigation techniques. Creativity, initiative, independent thinking, critical thinking, and problem solving skills are strongly preferred.
• Must be able to handle multiple tasks simultaneously.
• Requires the ability to read, write and speak effectively in English.
• Insurance verification and Medicaid eligibility experience highly desirable.

Years of Experience : Must have 1-2 years of progressively more responsible experience in a hospital registration, billing, and payment-processing environment in order to be familiar with internal policies and external third-party payer policies and procedures.

WORKING CONDITIONS

Physical Demands : Must have physical ability to move from one office / work area to another, frequently lifting binders, boxes, files, etc., normally up to 20 lbs., occasionally lifting heavier boxes of supplies or files, etc. Work will frequently require rounding on patient rooms (, walking, standing, sitting, and kneeling). Must be able to sit and / or stand for extended periods.

ProMedica