Patient Access Financial Advocate

Presbyterian is seeking a Patient Financial Advocate-Admitting

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 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 pre-billing/pre-adjudication 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.

This position is a Part Time (.45 to .89) - Exempt: No
• Job is based at 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

About Presbyterian Healthcare Services

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.

As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships.

Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.