Patient Financial Advocate Resume Samples

Description :

1. Responsible for the collection of patient out-of-pocket expenses through the effective evaluation of the patient's financial situation.
2. Conducted case by case financial evaluation of self-pay admissions assigned to determine if reimbursement is available through various government and non-government programs or other third party sources, including the unique handling of trauma patients.
3. Conducted interviews, gather documentation, and prepared summary in order to process applications for charitable consideration.
4. Resolved problems/issues that involve third-party payors ie., HMO/PPO's, BCBS, Medicaid, Medicare, commercial, workers comp, and other various carriers to avoid payment delay.
5. Responsible for timely follow-up of accounts with self-pay balances who qualify for the on-line Pre-service, daily in-house, and currently registered self-pay patients assigned to each financial advocate based on specific requirements.
6. Liaisoned for the hospital with VA Fee Basis Department Process and handles high dollar appeals and disputes.
7. Assisted patients that qualify for Medicaid with the application process.

Experience

2-5 Years

Level

Junior

Education

GED

Description :

1. Identified documents and collected patient responsibility money before or at the time of service.
2. Assisted patients with questions about financial arrangements, billing, collections, or other policies.
3. Coordinated placement and admission of patients into the hospital.
4. Coordinated interfacility transfers, admissions, and discharges.
5. Assured accurate admission class and order status for federal compliance and accurate census.
6. Performed regular audits to ensure accuracy.
7. Performed On-call weekend supervisor for Emergency Department.

Experience

5-7 Years

Level

Executive

Education

BA

Description :

1. Called insurance companies to verify insurance and eligibility of benefits using multiple websites.
2. Checked if preauthorization is needed.
3. Used Clear Quote obtaining how much monies are owed before scheduled procedures and surgeries.
4. Called patients and obtained demographic information.
5. Collected copays, deductibles, and coinsurance.
6. Worked closely with other hospital departments, doctor offices, and staff to ensure a smooth process.
7. Utilized Fax machines, Copiers, Word, Outlook, and Scanning.

Experience

10+ Years

Level

Senior

Education

BS

Description :

1. Posted payments, adjustments, transfer of responsibility, and refunds, as necessary Issue adjusted, corrected, and/or rebilled claims to insurance companies.
2. Answered questions from clerical staff and insurance companies.
3. Identified and resolved patient billing problems.
4. Prepared, reviewed, and sent patient statements to mailing service.
5. Reviewed accounts and made recommendations to the Senior Claims Billing Specialist regarding uncollectible accounts.
6. Performed dialing collection actions including contacting the insurance company, contacting the site, correcting and resubmitting claims to third party payers.
7. Prepared and posted daily deposits received from customer site (P.O.Box) and/or lockbox remittance.

Experience

2-5 Years

Level

Junior

Education

GED

Description :

1. Gathered patient information to initiate a medical record on all surgery patients.
2. Generated a procedure packet for each patient procedure.
3. Verified insurance for all patients through phone calls to a variety of insurance contacts and/or through online sources.
4. Provided front desk support including answering phone calls and managing incoming faxes.
5. Received/assisted/checked in patients and visitors.
6. Notified appropriate staff of patients' arrival.
7. Collected patient payments as needed via the Quick Pay system.
8. Verified completion of patients chart.

Experience

2-5 Years

Level

Executive

Education

G.E.D

Description :

1. Advocated for patients and their families to explore options for financial assistance for medical services.
2. Encouraged and assisted patients to establish a financial record keeping plan/system, utilizing the appropriate tools available.
3. Assisted to secure resources via written correspondence, electronic correspondence, and providing constant, thorough follow-up.
4. Maintained and verified insurances in the electronic health record system.
5. Maintained a constant high level of communication with families, individuals, peers, and physicians to assure the patient's needs are met.
6. Released information to persons or agencies according to regulations.
7. Assisted patients with the process of obtaining Medicaid.

Experience

2-5 Years

Level

Junior

Education

G.E.D

Description :

1. Worked with financially indigent patients who will undergo future medical services.
2. Consulted and screened patients for available programs including Medicaid, Medicare, SSD/SSI, county assistance, insurance eligibility, and hospital charity.
3. Accessed insurance websites and update patient medical records accordingly.
4. Worked closely with doctors' offices and nursing staff to obtain CPT codes and cost estimates for procedures.
5. Worked as an advocate for the patient and the hospital.
6. Certified enrollment counselor and have helped patients browse and obtain insurance via the insurance exchange.
7. Obtained insurance and/or eligible financial funding for services, that if not obtained, may result in the hospital not being reimbursed for services.

Experience

5-7 Years

Level

Executive

Education

BA

Description :

1. Executed Patient Access daily operations of screening Emergency Department self-pay patients for eligibility in various governmental and non-governmental programs.
2. Interviewed and accurately collected and recorded patient demographic and insurance information to complete the registration process.
3. Initiated and completed MA applications for eligible patients and followed up on assigned accounts to ensure follow-through on Government application submitted.
4. Developed a working relationship with patients based on good communication skills, enabling accounts to be processed quickly with government program eligibility.
5. Performed financial clearance functions including collections in Emergency Department, canceled accounts that have not had any patient cooperation, and are not eligible for any programs, and prepared accounts for Financial Assistance (Charity) review.
6. Served as a bilingual advocate interpreting and translating English to Spanish and Spanish to English to patients, clients, and their families.
7. Promoted patient satisfaction, serving as a liaison on behalf of the hospital and patient.

Experience

5-7 Years

Level

Executive

Education

GED

Description :

1. Identified several process improvements for business office functions; authored standard operating procedures.
2. Formulated an Excel model that reduced medical chart auditing time.
3. Managed up-front payment collection resulting in nearly consistent expected daily revenue.
4. Created a new insurance verification system that more adequately complies with company by-laws and decreased the verification process time.
5. Spearheaded an online payment imitative; tested functionality, and research resources.
6. Coordinated on-site biometric screenings and facilitate the Healthy Edge program.
7. Took ownership of facility social media, implemented site monitoring, and contributed to overall marketing strategy.

Experience

5-7 Years

Level

Executive

Education

GED

Description :

1. Reviewed daily census/worklist to identify self-pay patients to complete assessments with patients for financial assistance through charity programs and/or state Medicaid programs.
2. Knowledgeable in current government financial assistance programs like Wisconsin and Illinois Medicaid, and Crime victims.
3. Collected required documentation from patients to support applications submitted for review to state agencies by the online website or faxing the application to proper departments.
4. Had communication with patients, hospital staff, and other agencies to maintain updates on the process of the application or information that was needed.
5. Initiated Social Security application process for Social Security Disability and Supplemental Security Income.
6. Assisted in training all of the new-hires by providing side-by-side guidance and providing exceptional assistance when needed.
7. Experienced with Emdeon and other eligibility programs for verifying insurances.

Experience

2-5 Years

Level

Junior

Education

BA