Patient Financial Advocate Job

: Contacts third party payors, patients, and other responsible parties to resolve unpaid claims. Follows and maintains accounts to ensure timely reimbursement and ensures follow-up dates are determined and tracked. Some positions may use a stratified work list to follow up on accounts.
Researches and verifies accounts that are ready for collections.
Resolves claim denials or underpayments by preparing appeals in accordance with payor guidelines.
Responds to telephone calls and correspondence regarding account status, payment arrangements, and complaints or disputes.
Resolves billing or charge disputes or forwards problem accounts to the appropriate individual for resolution.
Documents actions and conversations in Epic to provide status and next action steps for other representatives.
Verifies that patient information, dates of services and coding are correct, and coordinates with Health Information Department to resolve coding discrepancies.
Coordinates with clinical departments to resolve billing issues or obtain additional claim information.
Informs patients or patient representatives of payment options and establishes payment plans.
May process patient financial statements and review for charity.
Assists in determining eligibility by contacting insurance carriers, including state assistance.
Resolves credit balances.
Determines or recommends charity or administrative write-offs.
Coordinates benefits for third party liability.

Knowledge / Skills / Abilities:

- Demonstrated potential ability to perform the essential functions as outlined above.
- Demonstrated human relations and effective communication skills.
- Demonstrated knowledge of commercial or government billing requirements, Health Care Financing Administration (HCFA) regulations, and customer service practices.
- Demonstrated knowledge of accounting principles, word processing, and spreadsheets.

Qualifications:
Required
- Four years experience with medical accounts receivable, insurance claims, or equivalency.

Preferred
- Comprehension of Medicaid eligibility guidelines and bilingual language skills may be preferred.

Requirements: