Financial Advocacy Associate

VALLEY MEDICAL CENTER

JOB DESCRIPTION

The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization.

TITLE: Financial Advocacy Associate

JOB OVERVIEW: This position is responsible to provide financial advocacy for patients and Valley Medical Center by exploring payer sources as well as payment options to ensure accounts are financially secure prior to rending services. This position provides self-pay price quotes, alternative financing information and information regarding financial assistance programs. All communications are conducted in a manner that will result in positive patient relations and reimbursement for services.

DEPARTMENT: Financial Advocacy

WORK HOURS: As assigned

REPORTS TO: Manager, Financial Access

PREREQUISITES:

Associate (2 year) degree required or equivalent experience, college (4 year) degree preferred.

Minimum three years'' experience with insurance verification, Medicaid eligibility application, revenue cycle functions, hospital/physician offices or related areas

Ability to use Microsoft Word and Outlook; EPIC system experience preferred.

QUALIFICATIONS:

Strong organizational skills and ability to prioritize tasks

Strong conflict resolution skills as well as interpersonal skills and ability to build rapport with a wide variety of individuals

Knowledge of payer reimbursement processes and insurance terminology

Basic understanding of procedure codes (CPT, HCPCS, ICD-10 coding, etc.)

Working knowledge of medical terminology

Ability to identify and solve problems independently

7. Demonstrates reliable attendance and job performance
8. Requires manual and finger dexterity and vision corrected to normal range.

UNIQUE PHYSICAL/MENTAL DEMANDS, ENVIRONMENT, AND WORKING CONDITIONS: See Generic Job Description for Administrative Partner.

PERFORMANCE RESPONSIBILITIES:

Generic Job Functions: See Generic Job Description for Administrative Partner.

Essential Responsibilities and Competencies:

Responsible to screen uninsured or underinsured patients for COBRA, Medicaid, Financial Assistance or other payer sources completing and submitting applications as required

Responsible for maintaining Navigator certification with Washington Health Benefit Exchange

Ability to research billing questions using EMR and billing systems, payer resources and is able to resolve or refer the customer to the appropriate resource

Responsible for timely communication with all customers; internal and external; patients and caregivers

Ability to research and identify circumstances affecting payment of self-pay accounts

Ability to partner with referring physician offices, insurance payers and financial clearance team members to complete financial clearance of services

Ability to communicate patient liability clearly and accurately while adequately explaining concepts such as deductible, coinsurance and/or copayment and how they may affect the cost of care

Responsible for complete documentation of all actions, conversations with patient, staff, referring offices that may collaborate on account/services

Collaborates with PFS, HIM, UM and IT regarding appropriate documentation. Coordinates insurance referral/authorization requirements with UM. Ensures accuracy of all in-patient insurance related registration.

Collaborates in all workflow design or process improvement work groups, as assigned by coordinator, manager or director and demonstrates awareness of financial risk containment both for Valley and the patient

Connects with self-pay patients to explore assistance options; may work with financial counseling or the business office

Informs patients of any convenient payment options (e.g., portal, mobile App)

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