Patient Financial Advocate Specialist
This individual is responsible for pre-screening and enrolling self-pay (uninsured and underinsured) patients for external financial assistance programs, with a primary focus on Medicaid. This individual is also responsible for assisting patients in the process of completing financial assistance applications, educating them about their financial responsibility, and helping them identify a path toward resolving their balances. This role involves communicating with patients both in person and over the phone, and requires a high level of customer service
- Pre-screens uninsured and underinsured patients to identify potential financial assistance opportunities.
- Assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs.
- Ensures financial assistance applications are accurately filled out and complete before approval.
- Works in conjunction with on-site state social worker or outside eligibility vendor to assist and complete the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility.
- Initiates comprehensive interviews to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs.
- Provides patients with personalized financial assessment-based KH financial program guidelines, Insurance coverage and estimated patient liability.
- Initiates payment arrangements, collect patient liability after financial assistance has been determined and applied.
- Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility.
- Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.)
Minimum Education
- High school diploma or GED required
- At least two years of appropriate work experience that would indicate a high level of communication skills and organizational ability.
Minimum Work Experience
- Financial counseling, eligibility screening, and/or Medicaid application processing experience strongly desired
- Prior experience performing community outreach preferred
- Familiarity with statutes and regulations that can impact financial conversations
Required Skills
- Broad knowledge of government Advocate programs, guidelines, and application procedures -
- Strong written and verbal communication skills
- Ability to effectively translate medical and administrative language into more familiar terminology - Strong attention to detail
- Ability to comply with procedural guidelines and maintain confidentiality