The Financial Advocate serves as the primary contact for patients regarding financial liability issues in accordance with established financial and credit policies. Individual must maintain and promote an attitude of professionalism as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self; consistently demonstrate excellent oral and written communication skills; possess the knowledge and skills necessary to provide interactive communications appropriate to the age of the patient being served; interact appropriately with third party payers, peers and other departments; and have the ability to relate well to people of a broad socio-economic mix. Position has frequent contact with patient financial services and patient access departments. The financial advocate is the contact person to serve as a liaison to explain hospital charges, financial assistance programs and providing various financial assistance forms. Responsible for screening self-pay patients at hospital bedside for eligibility in various governmental and non-governmental programs. Responsible for identifying all sources of potential payors including auto insurance, workersï¿½ compensation, commercial insurance, private insurance, TPL, etc. and assisting patients in the process of applying for any benefits for which they may be eligible. Position is responsible for validating inpatient insurance eligibility, inpatient insurance benefits and emphasis with collecting patient financial liabilities. Strong organizational skills and a commitment to teamwork are essential. Individual must have ability to work closely in a clinical setting involving some stressful situations.
Associateï¿½s Degree in business administration or healthcare related field. If no degree, candidate must agree to attend an accredited higher educational institution that offers a business administration or health care related field degree.
Those currently employed as a Financial Advocate and do not have the above educational requirements will be grandfathered in.
2 years in a healthcare related field; knowledge of basic registration and third party payer experience. Previous scheduling, registration, or call center experience. Should be familiar with statutes and regulations that impact collection of past due accounts and a broad knowledge of government assistance programs, guidelines and application procedures. Demonstrated ability to read, write, arithmetic, multiplication/division including fractions and decimals. Strong computer skills and ability to type 30 wpm, excellent customer service skills and interpersonal communication and telephone etiquette are required. Demonstrate ability to multitask and manage high volumes. Computer, fax machine, copier, multiline telephone. Individual is a self-starter and demonstrated ability prioritize work and manage multiple task in a sometimes stressful environment. Medical terminology, and basic knowledge base of CPT and ICD-9 codes, insurance coding and billing knowledge.
Bilingual, Prior work experience in bank industry, commercial or governmental insurance agency.
Position Requirement(s): License/Certification/Registration
Certified Healthcare Access Associate from NAHAM
1. Use a financial sequencing hierarchy to screen uninsured and underinsured patients for payment potential.
2. Review patient prior bad debt to ensure all financial assistance and payment arrangements are secured.
3. Communicate with patients to resolve current and prior patient liability prior to service.
4. Assist patients with completing financial assistance applications prior to service..
5. Financially clear patients prior to service by collecting current patient liability, establishing payment arrangements, resolving prior bad debt accounts, making Medicaid referrals, and initiating financial assistance applications prior to service.
6. Work with facility Registration Staff and Financial Advocates to ensure hand-offs occur from Pre-Access to the Point of Service.
1. Assist uninsured patients.
1.1 Review for potential insurance coverage by determining the patient has no current insurance coverage.
1.2 Screen patient for potential COBRA coverage by reviewing work history and current work status. Follow established payment hierarchy to collect current patient liability and prior bad debt account balances, establish payment arrangements, and initiate Medicaid, financial assistance and other applicable program applications.
1.3 Collect money owed from patients to ensure timely recovery of the outstanding accounts receivable.
1.4 Assign appropriate ï¿½financial clearanceï¿½ indicators to ensure patient hand-offs from Pre-Access to Registration Point of Service.
1.5 Review patient prior bad debt accounts to ensure are secured or financial assistance is on arranged Utilize bad debt indicators and registration alerts to identify patient prior bad debt accounts.
1.6 Contact patients with in-scope prior bad debts to resolve prior bad debt accounts.
2. Identify patients qualifying for Medicaid and Financial Assistance
2.1 Complete a financial screening to identify patients who are potentially eligible for Medicaid or financial assistance Complete online financial assistance eligibility forms and e-mail to servicing facility for signatures and collection of document
2.2 Refer patients who are potentially eligible to the Medicaid eligibility vendor.
2.3 Monitors and obtains necessary demographic and financial information in order to complete all financial assistance and charity applications.
3. Maintain effective communication and quality with members of the healthcare team.
3.1 Complete productivity reports as requested by management.
3.2 Review daily work as requested by management.
3.3 Remain current on changes in Department and Erlanger Policies and Procedures.
3.4 Serve as a liaison with the physician and/or physician office staff utilizing excellent guest relations.
3.5 Collaborate with other department and outside agencies to meet the needs of the patient and the organization.
3.6 Notify the supervisory team of incidents of errors.
3.7 Enter appropriate activity codes
4. Maintain confidentiality of information of the department.
4.1 Maintain confidentiality of departmental information according to established procedures with no reported errors.
4.2 Release confidential information only in accordance with the confidentiality policy and/or approval of the Director.
5. Contribute to the efficient operations of the department.
5.1 Complete special projects as assigned according to the established time frames.
5.2 Prepares and maintains reports of results as requested.
5.3 Explain insurance coverage for inpatient and outpatient admissions regarding self-pay balances by arranging payment for services for patients with co-pays, deductibles, co-insurance or with no insurance.
5.4 Determine deposit amounts for admission and contacts patients to obtain deposits as appropriate. Available to complete this task by going to units where patients are located and meeting with the patient/family members in person or telephone.
5.5 Verifies all inpatient insurance benefits and loads information into Invision system
5.6 Validates all inpatients admitted through the emergency department have a copy of driverï¿½s license, insurance card(s) and all necessary forms signed by patient prior to discharge. Information not obtained is explained in detail within shown notes of Invision.
5.7 Position is responsible for point of service collections
5.8 Identifies and reports equipment problems which require maintenance or repair.
5.9 Facilitate the efficient operations of the department by answering the telephone and assisting callers or visitors in any way possible.
5.10 Performs other duties as assigned.
6. Assist in delivering high quality health care services in a professional, compassionate, and courteous manner while respecting the dignity and individuality of each person who comes in contact with the organization by following the Standards of Excellence, the Standards of Behavior, and the Standards of Professional Appearance and Conduct.
6.1 Maintains patient privacy and confidentiality at all times according to established procedures.
6.2 Follow the Standard of Professional Appearance and Conduct and the Erlanger departmental dress code.
6.3 Communicates effectively and courteously answering assigned telephone lines within three rings identifying self at all times.
6.4 Assist visitors and patients in giving directions and information.
6.5 Communicate effectively and courteously with visitors, physicians, patients, and employees.
6.6 Introduces self and position to patient, families and visitors at all times.
6.7 Assess environment for safety hazards which could harm patients, visitors, or other hospital employees and report hazards to appropriate supervisors.
6.8 Collaborate with departments and outside agencies to meet the identified needs of the patients and organization.
7. The employee honors Erlanger Mission Statement, Vision Statement, and Core Values. The incumbent understands:
7.1 The incumbent demonstrates a commitment to high level of professional and ethical standards in his/her daily activities, consistent with the Code of Conduct and related to Erlanger policies.
7.2 The incumbent maintains integrity in business activities by following legal standards, maintaining confidentiality of patient and business information and reporting known or suspected misconduct.
7.3 The incumbent has completed the required annual general compliance training and any department specific training, as appropriate.
7.4 That Erlanger provides the highest quality of care to the community through respect, dignity, and compassion regardless of race, creed, national origin or the individualï¿½s ability to pay and;
7.5 That Erlanger provides leadership in pioneering new services through increased allocation of resources for research and education.