The Patient Financial Advocate (PFA) is responsible for providing complete registration and financial advocacy for the patient upon admittance to the hospital.
The PFA obtains specific demographic and financial information to determine patient's financial needs and secure maximum reimbursement.
The PFA assists uninsured and underinsured patients by applying for State, or Federal, Specialty programs, education of the Affordable Care Act, and presenting patients with payment information.
Data collected will be used to complete insurance notification, verification, and certification. The position acts as a liaison between patient / patient representative in a culturally diverse population and internal, external partners fostering open, professional, timely, courteous, and accurate communication.
Essential Functions and Responsibilities
- Subject Matter Expert in Registration and Financial Counseling.
- Screen patients and determine potential eligibility for State Medicaid (MAGI, LTC, and Federal Disability programs (SSI / SSDI) and completes the application process.
- Complete registration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and Coordination of Benefits.
- Deliver education in regards to explaining affordability programs, qualified health plans, essential health benefits, and rights when using insurance.
- Consult and provide patients with an affordable payment plan option while adhering to the Eskenazi Health payment plan guidelines.
- Maintains an understanding and remains current with Eskenazi Health's Financial Assistance Policy and procedures.
- Calculate and provide estimates to patients for services provided by Eskenazi Health.
- Follow up with the state on cases pending eligibility and / or contacting patient for additional information on pending accounts requiring more than originally provided.
- Add and term coverage properly, ensuring that billing is initiated when appropriate.
- Verifies information on appropriate accounts to determine insurance coordination of benefits.
- Assists with special projects; audits, reporting, research, etc.
- Maintains departmental and / or individual work queues and reports as required.
- Explains / answers patient billing inquiries and interprets statement data to resolve accounts.
- Documents patient account notes for all interactions / transactions in EPIC and / or Financial Assistance program.
- Maintains productivity and quality standards set forth by the department.
Job Requirements
Accredited Bachelor's degree; OR Two (2) years of experience in registration and financial counseling. High School Diploma or GED required.
- Certification in Healthcare Business Insights within 60 days of hire
- Indiana Navigators Certification within 45 days of hire
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