Patient Financial Advocate

Now Hiring a PATIENT FINANCIAL ADVOCATE- PMG Atrisco

Performs financial screening on hospital, Pre-registration, ER and outpatient account, high-deductible plan participants and self-pay patients. Requires thorough knowledge of assistance programs to include Financial Assistance application, Medicaid (PEMOSSA) application and other alternate resource programs in addition to full competency of Presbyterians policy for payment plan application. In depth understanding of benefits administration of PHS contracts and their respective in and out of network arrangements. This role requires comprehension of the pre-billing/pre-adjudication of claim filing to successfully identify out of pocket expense the patient should anticipate. Possess a broad understanding of Presbyterians affiliates and their billing methodologies. Successfully counsel patients and/or families regarding financial responsibilities to Presbyterian. Ability to use standardized procedures that emphasize assertive steps to resolve and gain reimbursement of patient financial obligatory amounts using CARES Behaviors. Ability to research disputed account balances and resolve accounts with outstanding residual balances. Escalates chronic no pay or bad debt accounts to superior. 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.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

Full Time - Exempt: No
• Job is based PMG Atrisco
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Ideal Candidate: Three to five years of healthcare experience in a physician office or hospital setting

Other information:
Academic Preparation:
*High school or equivalent
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

UPDATED: 10/26/2017

Education:
Essential:
* High School Diploma or GED

Responsibilities:
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

We offer more than the standard benefits!

Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:

https://www.phs.org/careers/why-work-with-us/benefits

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About Presbyterian Healthcare Services

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are 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, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

About Our Regional Delivery System

Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.

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 continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

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.