Benefit Advocate
Loyola

Job Info

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Employment Type:
Full timeShift:

Description:
benefit advocate
In this role, the Patient Benefit Advocate is responsible for coordinating payment sources and other activities related to securing reimbursement for hospital services rendered to patients who are either already admitted to our hospital, or who may be seeking to obtain services. The Patient Benefit Advocate I will educate and assist patients with understanding their insurance options, setting up payment arrangements, and collecting patient financial responsibilities, while also assisting the patient with any and all avenues of financial assistance available to them. The Patient Benefit Advocate I will perform all functions in a courteous and respectful manner, advocating for the patient's best interest and wellbeing.

Position Responsibilities:

• Works with patients and vendors in applying for and securing payment options. Works with contracted vendors/agencies to qualify applicants for insurance coverage.
• Educates patients on routine insurance coverage and financial assistance options, when appropriate. Assists with application process for patient coverage and financial assistance.
• Provides pricing estimates and communicates pre-service patient liability based on expected charges and potential coverage. Collects any patient liabilities due and performs routine cashiering functions.
• Performs benefit advocacy functions for patients on a pre-service, point of service and post-service basis. Interviews patients and/or their representatives, by adapting and utilizing interviewing techniques to meet respective needs, educational levels, and abilities of the interviewee, to accurately update demographic, clinical, financial and insurance data necessary to complete the benefit advocacy process and screen patients for financial assistance. Reviews prior account notes for past due balances and any information that might aid in the application/payment process, as well as documents all encounters and actions.
• Interacts and collaborates with numerous departments to resolve issues while also analyzing necessary information that will ensure hospital reimbursement. Initiates requests for charity care and recommends write-offs charity care adjustments, when appropriate. Monitors accounts in the self-pay or eligibility pending financial class and following up to provide account resolution.

Magis & Service Excellence Accountabilities:

• Responsible for consistently demonstrating our Magis values of Care, Concern, Respect and Cooperation through teamwork and effective communication in an effort to prevent and solve problems and to achieve quality outcomes, patient safety, customer satisfaction and a safe environment.
• Responsible for developing and maintaining an environment of service excellence as outlined in the Service Excellence standards.

Position Requirements:

Minimum Required:

• High School Diploma
• Specify Degree(s): Accounting or Business Administration, or related field
• 1-2 years of previous job-related experience
• Details: Past work experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities is required. Knowledge of insurance and governmental programs, regulations and billing processes e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly strongly preferred. Working knowledge of medical terminology, anatomy and physiology, and medical record coding (ICD-10, CPT, HCPCS) is preferable.

Preferred:

• Associates Degree
  
  

Licensure/Certifications:

• N/A

Computer Skills:

Required:

• Microsoft Excel
• Microsoft Outlook
• Microsoft Power Point
• Microsoft Word
• Preferred:
• EPIC

Required Skills:

• Ability to communicate verbally
• Ability to deal calmly and courteously with people
• Ability to deal with stressful situations
• Ability to finish tasks in a timely manner
• Ability to follow oral and written instructions and established procedures
• Ability to function independently and manage own time and work tasks
• Ability to lead work teams
• Ability to maintain accuracy and consistency
• Ability to maintain confidentiality
• Ability to organize workflow
• Ability to perform basic filing, office procedures and word processing
• Ability to work as an effective team member
• Other: Must be able to set, organize, and adapt quickly to changing work priorities. Must be able to work concurrently on a variety of tasks/projects in a fast paced, high energy, diverse environment with varied working styles. Excellent problem solving skills are essential. Ability to comprehend and retain information that can be applied to improving work processes and procedures to achieve appropriate service delivery.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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