Presbyterian is seeking a Patient Financial Advocate- HS General Surgery
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.
This is Full Time position - Exempt: NoJob is based at Presbyterian HospitalWork hours: Weekday Schedule Monday-FridayIdeal Candidate:
Three to five years of healthcare experience in a physician office or hospital setting
Qualifications Academic Preparation:*High school or equivalentExperience:Three to five years of healthcare experience in a physician office or hospital settingPrior billing office and collection experience preferredSignificant provider and patient interaction experienceAbilities:Demonstrates a commitment to Presbyterian s Sense of Mission by role modeling CARESBehaviors and appropriate customer service techniques to perform patient education and act as a resource and advocate to our patients and membersRequires 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 doneFamiliarity with the Affordable Care Act and healthcare s role in assisting patients and patients families with health care costsMust be able to interpret dataComprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scop. 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 timesAbility to manage conflict and appropriately request the help of a supervisor when appropriateEncounter 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 ofExceptional 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 dailyKeeps current on PHS financial policies, including payment plans, programs and other forms of funding. BenefitsAbout Presbyterian Healthcare Services
Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.
The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities—like challenges, webinars, and screenings—with opportunities to earn gift cards and other incentives.
As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships.
Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to USD $23.76/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs. Options Apply for this job onlineApplyShareEmail this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Need help finding the right job? We can recommend jobs specifically for you! Click here to get started.Application FAQs