Patient Advocate

TITLE: PATIENT ADVOCATE

GENERAL DESCRIPTION:

Act as a patient liaison to ensure the patient’s medical services are covered by their insurance (if applicable) and any patient with financial difficulties are given payment options.  Work with the Reception Department to ensure correct data is entered for all patients, relay patient information, and ensure proper collections.

DUTIES & RESPONSIBILITIES:

Direct Service

• Review and report daily Reception collection status.
• Call patients prior to appointment to inform them of any balance due or other finance related info.
• Handlepatient credit problems in a professional and proper manner.
• Work undisturbed credit for all patients with upcoming appointments.
• Work collection of past due patient accounts daily (Workque/Practice Management).
• Answer patient calls in 24 hour period.
• Correct patient demographics as needed.
• Inform patients of past due balance via phone, letter, or in-person and document the encounter.
• Research problems related to patient bills.
• Work with Medical Biller matters related to claim rejections on behalf of the patient.
• Audits medical records to ensure correct documentation supports billing.
• Collect, log, and post patient payments.
• Keep all documents, reference materials, manuals and forms organized.
• Generate monthly reports of Accounts.
• Ensure all encounters and demographics are correct (Prescrub) prior to the coder transmitting claims.

ESSENTIAL JOB REQUIREMENTS:

• Enter appropriate up-to-date information in the computer billing system and Routing sheet.
• Review regularly all bulletins and correspondence from carriers for up-to-date changes and keep for easy reference.
• Knowledge of basic business office equipment, computer, copier, calculator, telephone, and etc
• Familiarity with common business and health care insurance/provider terminology.
• Ability to utilize basic mathematical skills, adding, subtracting, multiplying, computing percentages and decimals.
• Ability to establish and maintain effective working relationships.
• Reports quality issues to management immediately.
• Ability to work independently within established system, policies, and procedures to organize work and to set priorities to accomplish multiple tasks within a given time frame.
• Ability to accept and respond to change in the work environment in a way that promotes organizational goals and objectives.
• Act as a back up to Receptionist as needed.
• Other responsibilities and tasks as assigned.

GENERAL

• Conduct all professional activity in an ethical manner.
• Conform to all applicable policies and procedures.
• In conjunction with other staff assist in identifying and eliminating any situation which jeopardizes the health and/or safety of clients, staff, or others who come in contact with community mental health center operations.
• Utilize continue education programs, literature, workshops and other training aids to continually improve coding and reimbursement skills.
• In conjunction with supervisor, complete and implement Individual Professional   Development Plan.
• Assist in assuring Edgewater Systems compliance with all related licensing and accreditation requirements.

ESSENTIAL JOB REQUIREMENTS:

• Must be able to use a multi-line phone system.
• Good verbal communication skills
• Must have excellent phone etiquette.
• Basic Bookkeeping skills
• Ability to comprehend established office routines and policies.
• Learns quickly from oral and written instructions.
• Ability to perform mathematical tasks.
• Knowledge of some medical terminology.
• Understand the ethics of confidentiality.
• Good organization skills and good health.
• Tact and diplomacy

SUPERVISED BY: Administrator/Manager

WORKERS SUPERVISED: None

MINIMUM QUALIFICATIONS:

• Education– High School graduate or equivalent, Certification preferred
• Experience–Two years experience in a primary healthcare provider facility with third party billing and collections in accounts receivable required. Other combinations of additional training and relevant experience may be considered. Ability to type at a rate of 40 words per minute