PATIENT FINANCIAL ADVOCATE
Company: Presbyterian Healthcare Services
Location: Rio Rancho
Posted on: June 12, 2021
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Job Description:
Summary: 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 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 scope Education: Essential: * High School Diploma or
GED Benefits are effective day-one (for .45 FTE
and above) and include: About Us Presbyterian's story is really the story of
the remarkable people who have chosen to work here. Starting with
Reverend Cooper who began our journey in 1908, the hard work of
thousands of physicians, employees, board members, and other
volunteers brought Presbyterian from a tiny tuberculosis sanatorium
to a statewide healthcare system, serving more than 700,000 New
Mexicans.
Type of Opportunity: Full Time
FTE: 1.000000
Exempt: No
Work Schedule: Days
Performs financial screening on hospital and medical group account
activity to identify residual balances, high-deductible plan
participants and self-pay patients
Requires thorough knowledge of assistance programs to include
Community Benefit Application, Medicaid (PEMOSSA) application where
applicable and other alternate resource programs in addition to
full competency of Presbyterian policy for payment plan
application
Research disputed account balances and resolve accounts with
outstanding residual balances
Must possess in depth understanding of benefits administration of
PHS contracts and their respective in and out of network
arrangements
Comprehension of the pre-billing/pre-adjudication of claim filing
to successfully identify out of pocket expense to counsel patient
and/or families regarding financial responsibilities to
Presbyterian
Escalates chronic no pay or bad debt accounts to supervisor
Refers patients without insurance coverage to the Financial
Advocacy Center located at Main PHS for navigation of options to
manage healthcare costs, including using the Market Place for
obtaining health insurance coverage
Other duties as assigned
Presbyterian Healthcare Services is a locally owned, not-for-profit
healthcare system of nine hospitals, a statewide health plan
and a growing multi-specialty medical group. Founded in New Mexico
in 1908, it is the state's largest private employer with
approximately 11,000 employees.
We are part of New Mexico's history - and committed to its future.
That is why we will continue to work just as hard and care just as
deeply to serve New Mexico for years to come.
About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American
influences contribute to a culturally rich lifestyle. Add in
Albuquerque's International Balloon Fiesta, Los Alamos' nuclear
scientists, Roswell's visitors from outer space, and Santa Fe's
artists, and you get an eclectic mix of people, places and
experiences that make this state great.
Cities in New Mexico are continually ranked among the nation's best
places to work and live by Forbes magazine, Kiplinger's Personal
Finance, and other corporate and government relocation managers
like Worldwide ERC.
New Mexico offers endless recreational opportunities to explore,
and enjoy an active lifestyle. Venture off the beaten path,
challenge your body in the elements, or open yourself up to the
expansive sky. From hiking, golfing and biking to skiing,
snowboarding and boating, it's all available among our beautiful
wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer
with smoke free campuses.
Keywords: Presbyterian Healthcare Services, Rio Rancho , PATIENT FINANCIAL ADVOCATE, Other , Rio Rancho, New Mexico
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