Presbyterian Healthcare Services
Patient Financial Advocate- HS General Surgery
Presbyterian Healthcare Services, Albuquerque, New Mexico, United States, 87101
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 including Financial Assistance application, Medicaid (PEMOSSA) application and other alternate resource programs, in addition to full competency of Presbyterian's 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 expenses the patient should anticipate. Possesses a broad understanding of Presbyterian’s affiliates and their billing methodologies. Successfully counsels patients and/or families regarding financial responsibilities to Presbyterian. Uses standardized CARES Behaviors to resolve and gain reimbursement and to educate patients as a resource and advocate. 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 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 expectations for payment when applicable. Set up payment plans in Epic per guidelines. Ensure registration accuracy to coordinate and identify claims where filing errors have occurred and resubmit the claims to payors for consideration. Financial Accountabilities: Collect identified patient financial obligation amounts including residual balance if applicable. Refer as appropriate to on-site Financial Advocate, or for uninsured to the Financial Advocacy Center. Follow PMG cash handling policies and balance daily. Keep current on PHS financial policies, including payment plans, programs and other forms of funding. 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, understanding what and how work is done and why. Familiarity with the Affordable Care Act and healthcare’s role in assisting patients and families with health care costs. Must be able to interpret data. Comprehension of billing methodology for an integrated delivery system including lab and other ancillary services. Benefits
Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits. The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities—like challenges, webinars, and screenings—with opportunities to earn gift cards and other incentives. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke-free campuses. About Presbyterian Healthcare Services
Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in 1908, Presbyterian is the largest private employer in New Mexico, serving over 580,000 health plan members. AA/EOE/VET/DISABLED. Compensation
Base pay range: $15.99/hr - $23.76/hr. Maximum Offer for this position is up to USD $23.76/Hr. Compensation disclaimer: The range takes into account factors including experience, training, internal equity, and other business needs. Seniority level
Mid-Senior level Employment type
Full-time Job function
Customer Service Industries: Hospitals and Health Care
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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 including Financial Assistance application, Medicaid (PEMOSSA) application and other alternate resource programs, in addition to full competency of Presbyterian's 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 expenses the patient should anticipate. Possesses a broad understanding of Presbyterian’s affiliates and their billing methodologies. Successfully counsels patients and/or families regarding financial responsibilities to Presbyterian. Uses standardized CARES Behaviors to resolve and gain reimbursement and to educate patients as a resource and advocate. 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 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 expectations for payment when applicable. Set up payment plans in Epic per guidelines. Ensure registration accuracy to coordinate and identify claims where filing errors have occurred and resubmit the claims to payors for consideration. Financial Accountabilities: Collect identified patient financial obligation amounts including residual balance if applicable. Refer as appropriate to on-site Financial Advocate, or for uninsured to the Financial Advocacy Center. Follow PMG cash handling policies and balance daily. Keep current on PHS financial policies, including payment plans, programs and other forms of funding. 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, understanding what and how work is done and why. Familiarity with the Affordable Care Act and healthcare’s role in assisting patients and families with health care costs. Must be able to interpret data. Comprehension of billing methodology for an integrated delivery system including lab and other ancillary services. Benefits
Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits. The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities—like challenges, webinars, and screenings—with opportunities to earn gift cards and other incentives. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke-free campuses. About Presbyterian Healthcare Services
Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in 1908, Presbyterian is the largest private employer in New Mexico, serving over 580,000 health plan members. AA/EOE/VET/DISABLED. Compensation
Base pay range: $15.99/hr - $23.76/hr. Maximum Offer for this position is up to USD $23.76/Hr. Compensation disclaimer: The range takes into account factors including experience, training, internal equity, and other business needs. Seniority level
Mid-Senior level Employment type
Full-time Job function
Customer Service Industries: Hospitals and Health Care
#J-18808-Ljbffr