PATIENT CARE ADVOCATE/INSURANCE SPECIALIST

Are you a purpose driven and looking to make a difference in Memphis? Friends For All is looking to add to our team!

Why Friends For All :

For more than three decades, Friends For All (formerly Friends For Life) has been preventing the spread of HIV and helping those affected by HIV / AIDS live well.

Our holistic, client-centered approach provides a variety of services coordinated through one centralized model. We strive to address the roots of need-including stigma and inequality-to improve health and wellness for everyone we serve.

Our goal is to eliminate new transmissions of HIV in Memphis and the Mid-South and empower those living with HIV to become their healthiest, happiest selves .

What is in it for you :

• A commitment to work-life balance with : (up to 38 Days Off)
• 12 accrued vacation days per year
• 12 accrued sick days per year
• 14 paid holidays, including Your Birthday!
• Sick Bank allows employees to donate sick time to other employees with a serious health condition who have no remaining sick or vacation
• Flex Schedule may be available based on position after introductory period
• Employer-sponsored health, dental, and vision insurance with two PPO medical and Dental plans. Costs for employee per pay period (bi-weekly)
• BCBS PPO Plans
• PPO Gold premium $28.88
• PPO Platinum premium $56.15
• Dental Plans
• PPO Low $ 1.14
• PPO High $5.81
• Vision premium $ 1.41
• 401k program with up to 3% employer match starting immediately
• Employer-paid basic life insurance valued at $50,000
• Employer-paid Short-term disability
• Voluntary Life and AD&D, Long-term disability
• Flexible Spending Accounts for healthcare and dependent care
• Student Loan Forgiveness Programs
• Employee Assistance Program with in person counseling options

To Learn More about Working at FFA : Go to https : / / www.friendsforall.org / careers

JOB TITLE :

Patient Care Advocate / Insurance Specialist

EXEMPT (Salaried) or NON EXEMPT(Hourly) :

NON-EXEMPT

DEPARTMENT : Clinical Services

Clinical Services

STATUS : Full-Time

Full-Time

REPORTS TO :

Revenue Cycle Management Coordinator

REGULAR HOURS :

M-T (11 : 30am - 8 : 00pm)

W - F (7 : 30am - 4 : 00pm)

JD REVISION DATE : 5.24.24

5.24.24

SUMMARY :

The Friends For All Corporation Patient Care Advocate / Insurance Specialist will be responsible for educating individuals, families, and community partners about health insurance and coverage options available through the Health Insurance Marketplace (part of the Affordable Care Act) or Medicaid.

They also provide support to the Medical Receptionist and complete administrative and data entry tasks. The Patient Care Advocate / Insurance Specialist conveys accurate information to help consumers make informed decisions about healthcare coverage, providing both in-person and virtual one-on-one enrollment assistance.

The Patient Care Advocate / Insurance Specialist does community outreach to raise awareness of the Marketplace and the availability of enrollment assistance.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Complete all CMS required training for Insurance Navigator certification.
• Assist individuals with applications for health insurance programs (Marketplace, Medicaid), including explaining information accurately and in understandable terms, interviewing consumers to obtain information needed for application, and facilitating computer-based enrollment.
• Maintain expertise in eligibility, enrollment and program specifications and provide information to consumers in a fair and impartial manner.
• Educate the public about the Marketplace and health insurance affordability programs.
• Respond to consumer calls or texts (OhMD) received through seeking answers to health insurance questions or to schedule Navigator appointments.
• Ensure the privacy and security of consumers' personally identifiable information and comply with federal regulations governing Navigators.
• Contact insurance carriers to verify patient's insurance eligibility, benefits, and requirements.
• Request, track, follow-up and obtain medical and pharmacological pre-authorization from insurance carriers within time allotted for services.
• Identify and enroll clients in insurance assistance programs to help with premiums and co-pays.
• Manage and reconcile client insurance assistant programs and necessary payments for monthly premiums in coordination with Pride life and Grantee Payer Services, HIPCSA, and Oral Health.
• Maintain a caseload of clients who are uninsured and navigate them into eligible coverage and ensure they maintain insurance coverage.
• Perform clerical duties and back up for medical reception such as answering and transferring calls; checking voicemails and returning calls;

responding to text messages and emails; shipping and mailing, processing documents received via fax; etc.

Complete proper, accurate and timely documentation of services in writing and in Athena, CAREware, Evaluation Web, Redcap, Apricot, and any other database, as required.

ADDITIONAL DUTIES AND RESPONSIBILITIES :

• Regular and predictable punctuality and attendance is required
• Return all calls, emails and text in a timely manner.
• Participate in weekly or biweekly coaching sessions with supervisor
• Complete Performance Reviews and SMART GOALS
• Participate in All Staff Meetings, In-Service Days and Mandatory Trainings
• May need to travel in personal vehicle to meet staff, clients, or community partners at FFA locations or at other locations to meet the needs of the position
• Duties and responsibilities may be added, deleted or changed at any time at the discretion of management, formally or informally, either verbally or in writing.

SUPERVISORY RESPONSIBILITIES :

N / A

QUALIFICATION REQUIREMENTS :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.

• High school diploma or GED (required)
• Bachelor's degree preferred in Healthcare Administration, Human Services, Public Health, or a similar field, or 5+ years equivalent experience.
• Must have 2+ experience as an insurance enrollment specialist, patient navigator, or similar role in a healthcare setting. (required)
• Must have 2+ years of clerical / front desk experience (required)
• Must have 2+ years of office management experience (preferred)
• Must have 2+ years of experience in medical billing and coding (preferred)
• Experience working with electronic health records and other documentation platforms (required)
• Good strategic / critical thinker, self-starter, goal-oriented
• Excellent verbal and written communications.
• Ability to operate with purpose, urgency and accuracy in a fast-paced, deadline-driven environment with particular attention to detail and organization
• Ability to work with a diverse client population
• Strong relationship-builder both with team and clients (internal and external)
• Ability to follow verbal and written instructions.
• Computer skills : ability to efficiently navigate the Internet and input data into applicable systems; familiarity with MS Office 365, especially Outlook and SharePoint, Adobe, TEAMS and Zoom
• Ability to define problems, collect data, establish facts, and draw valid conclusions
• Maintain confidential information and adhere to all Friends For All policies and procedures regarding sharing of financial information and Protected Health Information (PHI).

CERTIFICATES, LICENSES, REGISTRATIONS :

• Certification in medical billing and coding (preferred)
• Certified Insurance Enrollment Specialist (preferred)
• Must have a valid State Driver's License, provide proof of automobile insurance coverage to employer at all times and have an automobile to be used daily.

WORK ENVIRONMENT :

We are a mission driven organization made up of people committed to cultivating growth and learning. We believe in providing care for all our clients while providing a welcoming, balanced environment for all our employees.

By joining our team, you are joining a group of community-focused professionals who connect people with care.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• Must be sensitive to the culturally and racially diverse nature of clients, patients, employees, and visitors.
• Must be able to interact with everyone in a friendly, helpful manner.
• Embodies FFA Values :
• Equity and Acceptance
• Trailblazing, Creative and Fearless
• Joy and Fun
• Collaboration and Teamwork
• Service
• Awareness

ADA SPECIFICATIONS :

Physical and cognitive demands that must be met in order to successfully complete the essential

functions of the job. Reasonable accommodations may be made to enable individuals' disabilities to perform the essential functions unless the accommodation would impose an undue hardship on the organization.

• Requires ability to speak audibly and listen actively.
• Requires ability to use computers, telephones and other office equipment.
• Requires ability to sit for extended periods.
• May require occasional bending and lifting up to 25 pounds.
• May require periodic local travel.

OSHA CATEGORY :

This position performs tasks that may involve exposure to blood, body fluids, or tissues. Training will be provided per Standard Operating Procedure for your area of operation.

All FFA employees are offered the opportunity to receive the Hepatitis B vaccination series.

COMMENTS :

This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job.

It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.

Friends For All is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.