Patient Access Financial Advocate

Now hiring a Patient Financial AdvocateAdmitting

Performs financial screening on hospital Preregistration ER and outpatient account highdeductible plan participants and selfpay 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 prebilling/preadjudication 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 its not just what we do that matters. Its how we do it and it starts with our incredible team. From Information Technology to Food Services and beyond our nonclinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Part Time .45 to .89 Exempt: No
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Varied Days and Hours
• Benefits: PRN/PT (working less than a .45 FTE) employee benefits available for this position such as medical gym memberships and an employee wellness program.

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.

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 Blue
  
  C.A.R.E.S Behaviors:
• Demonstrates CARES behaviors of Collaborate be Accountable Respect Engage and Serve to all whom you encounter
  Professional Requirements:
• Pass annual competency exam for all areas of responsibility.
• Attend Quarterly MSO meetings.
• Attend Staff meetings
• Attend Employee Forums

All benefitseligible Presbyterian employees receive a comprehensive benefits package that includes medical dental vision shortterm and longterm disability group term life insurance and other optional voluntary benefits.

Wellness
Presbyterians Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your wellbeing. Earn gift cards and more by taking an active role in our personal wellbeing 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 notforprofit healthcare system of nine hospitals a statewide health plan and a growing multispecialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 14000 employees including more than 1600 providers and nearly 4700 nurses.

Our health plan serves more than 580000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drugfree and tobaccofree employer with smoke free campuses.