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Brown University · 1 month ago

Patient Financial Advocate

United States

Full-time

Remote

Entry, Mid Level

$20.55/hr - $33.93/hr

2+ years exp

Brown University Health is dedicated to providing comprehensive patient support, and they are seeking a Patient Financial Advocate to serve as a liaison between patients and the healthcare system. This role involves assisting patients and families in understanding and managing their medical expenses, securing resources, and navigating insurance processes.

EducationHigher EducationUniversities

Growth Opportunities

Responsibilities

Assumes an advocacy role with patients and or families and their surrogates regarding the resolution of outstanding patient accounts. Arranges and negotiates payment conditions and plans and advises and counsels patients regarding available resources from which payments can be made

Interviews patients and family members relative to their financial and dependency status or other factors, which may help promote eligibility for medical assistance or other state and federal programs

Secures legal counsel and aid for patients and families. Assists patients in obtaining documentation necessary to apply for public assistance

Maintains a continuing review of files, records and other forms of documentation on state and federal programs and regulations

Verifies patient insurance coverage (both primary and secondary) online or by telephone

Obtains and verifies coverage authorizations for scheduled and unscheduled patients, to include all sources such as Worker’s Compensation, Medicare Secondary Payer (MSP), Medicare liability, liens, etc

Establishes level of insurance benefits and expected payment for selected services. Determines the patient’s portion of payment, when applicable, and communicates to patient

Ensures referrals are obtained and confirms accuracy of the Primary Care Physician (PCP)

Reviews variety of reports and records to ensure that referrals and pre authorizations from insurance companies have been received

Confirms patient eligibility with insurance carriers and obtains visit authorizations as necessary

Contacts third party payers to obtain pre authorizations in accordance with established policies

Collaborates with physicians and mid-level providers to schedule peer-to-peer discussions to obtain prior authorization of services denied by the patient’s insurance

Coordinates all information for managing insurance denials

Collaborates with various Brown University Health personnel to resolve billing issues, prior authorizations, denials, and insurance denials/write-offs

Regularly participates in business team meetings with staff and management to make recommendations where there are perceived problems

Performs other duties as required to support the operations of the department, including, but not limited to, registering patients, scheduling appointments, scanning and faxing documents

Qualification

Third-party coverage knowledgePrior authorization processMedical terminology knowledgeAnalytical skillsInterpersonal skillsDatabase managementCPTICD knowledgeOrganizational skills

Required

Knowledge of third-party coverage, prior authorization process, referrals, etc

Current knowledge of state and federal resources available for needy and disabled, including familiarity with forms and documents necessary to file appeals on denied claims

Demonstrated interpersonal skills to effectively communicate with patients, family members, Brown University Health employees, third party payers and state and federal representatives and other government service agencies

Ability to operate a computer to access information and to prepare and maintain related records and reports

Possess strong medical terminology knowledge and clear knowledge of Current Procedural Terminology (CPT), International Classification of Diseases (ICD), and registration information

Strong organizational skills to effectively plan, direct, and manage high volume of orders requiring prior authorization

Analytical skills to evaluate effectiveness of workflow, make recommendations for change and to develop, review and evaluate various records and reports

Two years progressively responsible experience in health care with a heavy emphasis in one or more of the following areas: patient care environment, health care operations, database management, prior authorizations, referrals, documentation, and departmental operations

Excellent analytical and critical thinking skills and a focus for detail is needed

Preferred

Knowledge of coding in a healthcare environment is a plus

Company

Brown University

Glassdoor4.4

Brown University is an Ivy League research university that provides undergraduate and graduate programs. It is a sub-organization of Brown University Health.

Founded in 1764

Providence, Rhode Island, USA

1001-5000 employees