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Advocate Aurora Health · 1 hour ago

Financial Advocate

Aurora St Lukes Medical Center - 2900 W Oklahoma Ave

Full-time

Onsite

Entry, Mid Level

$22.50/hr - $33.75/hr

2+ years exp

Advocate Aurora Health is a leading nonprofit integrated health system in the United States. The Financial Advocate acts as a liaison between health services and consumers, educating them on financial responsibilities and assisting with coverage programs and financial assistance applications.

Health Care

Responsibilities

Acts as a liaison between health services and the consumer to provide education on costs, funding possibilities and payment options

Educates consumers on the cost of care and assists them in the planning and management of their financial responsibility

Pre-screens self-pay patients to determine if they are eligible for coverage programs and assists patients or family members with completing financial assistance applications, as necessary

Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service

Communicates patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments and how they may affect the cost of care

Explains how non-covered and out-of-network services factor into the out-of-pocket cost

Requests upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances

Establishes payment arrangements in advance of scheduled services when applicable, communicating due dates and the amount of each installment

Interviews uninsured patients to assess for qualifying financial needs

Identifies available assistance programs and coordinates with patient to complete paperwork and applications for any potential coverage(s)

Continues follow-up efforts to obtain a funding source for patient’s health services

Initiates credit scoring to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs through a comprehensive patient interview

Works in conjunction with state social worker and/or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility

Demonstrates working knowledge of insurance benefits, insurance companies, and Marketplace insurance options, and stays informed of other payer sources entering the markets

Educates physician office/patient on the organization’s applicable policies such as Financial Assistance Policy, Patient Financial Responsibility, Non-Covered Services, and Deferral of Care

Coordinates with provider office to determine scheduling options based on the need to secure funding and clarify patient’s financial responsibility

Stays current on regulations and eligibility requirements for government funding, especially Medicare and Medicaid

Understands and complies with all internal charity care policies and processes

Understands, complies with, and can articulate federal regulations around 501R

Performs in a HIPAA-compliant manner with all pertinent patient interviews, including management of demographic data, topics discussed, and actions taken

Collaborates with peers in the operational flow for uninsured patients or patients that are concerned about costs for upcoming services

Serves consumers in various settings, including virtual, bedside, Emergency Department room, clinic exam room, Urgent Care, consult space, or a Financial Resource Specialist office

Qualification

Insurance knowledgeFinancial assistance applicationsPatient access experienceMedical coding knowledgeHIPAA complianceCustomer service skillsProcess improvementCommunication skills

Required

Typically requires 2 years of experience in Patient Access, health care, insurance industry, or in a customer service setting

Ability to communicate clearly and proactively to management about issues involving customer service and process improvement opportunities

Ability to articulate explanations of HIPAA and EMTALA regulations as they relate to all patient interactions within the operational flow involving the Financial Advocate, either virtually or in person

Has solid knowledge of how various types of insurances operate related to denials and appeals processes

Basic medical coding knowledge. Understanding of insurances, billing and denials

Ability to use a combination of scripted notes and clear, written communication when documenting in patients' accounts

High School Graduate, or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)