Transformations Care Network · 16 hours ago
Patient Financial Advocate Senior
Transformations Care Network (TCN) is committed to improving accessibility in behavioral health. The Patient Financial Advocate Senior will support patients with complex billing inquiries and payment solutions while collaborating with cross-functional teams to resolve outstanding balances and enhance patient satisfaction.
HealthcareHealth CareMental Health
Responsibilities
Manage inbound escalations from Patient Services Representatives
Conduct detailed account reviews within NextGen PMS to reconcile complex balances
Investigate payment discrepancies, insurance processing issues, and posting errors
Coordinate with internal RCM, Operations and payer teams when resolution requires cross-functional review
Identify trends in recurring patient complaints and recommend workflow improvements
Process and make recommendations on Financial Hardship Applications
Establish customized payment arrangements within policy guidelines
Evaluate hardship considerations and assist patients with financial assistance applications
Discuss high-balance accounts with sensitivity and professionalism
Support prevention of external collections placement through proactive resolution
Guide patients through insurance explanations, appeals guidance (when appropriate), and benefit education
Handle emotionally charged or complex patient interactions with professionalism
Apply conflict resolution techniques to maintain trust and positive patient relationships
Serve as an escalation point for unresolved complaints before leadership involvement
Maintain composure and sound judgment under pressure
Maintain detailed, structured documentation within patient accounts
Ensure all payment arrangements and adjustments are clearly noted and policy compliant
Follow HIPAA and organizational privacy standards
Adhere to internal financial assistance and adjustment policies
Support organizational goals related to:
Reduction in aging accounts
Decrease in external collections referrals
Improved payment plan adherence
Increased patient satisfaction scores
Monitor promise-to-pay compliance and initiate follow-up outreach when necessary
Participate in QA review and mentor Tier 1 representatives as needed
Monitor daily call center performance metrics including call volume, abandonment rate, average speed to answer (ASA), average handle time (AHT), and service level adherence
Identify trends in peak call times and recommend staffing or workflow adjustments to maintain service levels
Proactively address elevated abandonment rates or extended hold times by partnering with the Supervisor to implement corrective actions
Review call data to identify recurring patient concerns, billing confusion trends, or systemic process gaps
Support quality assurance initiatives by correlating performance metrics with call outcomes and patient satisfaction indicators
Assist in developing performance improvement plans when dashboard trends indicate service risks
Serve as a backup support resource during high-volume periods to ensure service level consistency
Maintain knowledge of mental health billing, department policies and procedures
Develop and maintain positive working relationships with cross-functional teams, teammates and Payor representatives and other key stakeholders
Consistently meet or exceed the department productivity and quality standards and performance requirements
Collaborate as needed to identify and resolve underpayments and overpayments
Other duties and responsibilities as assigned including but not limited to:
Work overtime with little or no notice as needed
Attend team meetings, phone conferences, and training as needed
Qualification
Required
High school diploma or equivalent
4+ years experience in healthcare revenue cycle, patient accounts, or medical billing
Advanced understanding of insurance processing, EOB interpretation, and patient responsibility
Experience handling escalated patient financial conversations
Strong system navigation skills
Demonstrated ability to manage complex accounts independently
Intermediate computer skills and proficiency in MS word, excel outlook and database management and internet usage
Preferred
5+ years experience in healthcare revenue cycle and patient account management
Prior call center or high-volume inbound call experience
Advanced understanding of insurance processing, EOB interpretation, and patient responsibility
Experience handling escalated patient financial conversations
Strong system navigation skills (NextGen PMS experience preferred)
Demonstrated ability to manage complex accounts independently
Certified Revenue Cycle Representative or other billing certification
Benefits
Medical
Dental
Vision
Low-cost virtual care
Dependent and domestic partner coverage
401K
Comprehensive onboarding
Ongoing educational resources
Company
Transformations Care Network
Outpatient mental health clinics offering comprehensive care.
Funding
Current Stage
Growth StageLeadership Team
Brian Wheelan
Chief Executive Officer
Recent News
EIN Presswire
2025-10-31
Behavioral Health Business
2025-10-01
Company data provided by crunchbase