Job Summary :

The Patient Financial Advocate (PFA) position serves as the hospital’s primary contact for all patient billing inquiries, customer service, and financial assistance needs. Acts as a liaison between HRH hospitals patients, providers, and payers for all post-care matters related to account resolution. Provides information regarding hospital billing practices, policies, and patient billing statements. Assists patients in understanding billing statements to ensure swift resolution of outstanding balances. Fulfills the organization’s mission of care and service by providing superior customer service to the patient community. This position 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.

Job Description

Essential Responsibilities: 

* Acts as primary contact for customers which have questions or requests regarding accounts via phone, on-site walk-in's, email, Epic MyChart, or different websites.
* Provide patient estimates to our customers when price shopping whether patient are uninsured or looking to see what balances might be with current insurance coverage.
* Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. within a specific response-to-call timeframe and with the intent to resolve the caller’s concern immediately.
* Responds promptly to patient inquiries regarding hospital billing procedures, policies, and statements.
* Utilizes multiple resources to resolve patient inquiries while on the phone or preparing/reviewing billing correspondence.
* Collects patient payments and follows levels of authority for posting adjustments, refunds, and contractual allowances.
* Understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB).
* Documents all patient accounts activities concisely, including future steps needed for resolution.
* Prepares written responses to patients and customers regarding account resolution and complaint recovery.
* Interacts effectively with other administrative departments and hospital service areas on a daily basis to facilitate patient account resolution.
* Identifies barriers to efficient departmental operations and takes an active role in developing appropriate and effective solutions.
* Ensures financial assistance applications are accurately filled out and complete then applying appropriate adjustment and/or following HRH application processing guidelines for approvals.
* Works in conjunction with on-site state social worker or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility.
* Helps patients develop a plan to resolve their liabilities, including by setting patients up on payment plans according to HRH guidelines.
*Ability to provide full coverage for most positions within the department during vacations or illnesses.
* Performs other duties as assigned.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the associate for this job. Duties, responsibilities and activities may change at any time with or without notice. 

Education and Experience Required: 

1. Must be a high school graduate or equivalent.

2. Experience of 1-2 years with patient billing and account payment procedures within a health care organization is preferred.

Work Shift :

Varied Shifts (United States of America)

Scheduled Weekly Hours :

16