Financial Advocate

Company :

Allegheny Health Network

Job Description : 

GENERAL OVERVIEW:

This job will coordinate and assist Allegheny Health Network (AHN) patients with a financial risk to AHN related to financial obligations for both the technical and professional billing systems.  This will be done by serving as an escalated contact for the patient and initiating outreach to AHN patients with a financial risk.  Patient satisfaction will be ensured by following department policies and procedures while assisting patients.

ESSENTIAL RESPONSIBILITIES

• Initiate patients in applying for alternative payment programs including, but not limited to Medical Assistance, Addison-Gibson grants, Cobra, AHN’s Financial Assistance program, or payment plans.  Follow up with patients/vendors in relation with to alternative payment programs. (30%)
• Processes Financial Assistance application for approval/denial.  Identifies accounts for patient refunds related to Financial Assistance, and processes refunds to patients.  Posts appropriate adjustments/retractions to the accounts receivable system related to Financial Assistance. (30%)
• Documents the accounts receivable system with all pertinent information.  Uses critical thinking skills that ensures that accurate demographic and payer information is correctly reflected in the billing system, discovering unbilled insurance and facilitate billing of claims, identifying deductibles, out-of–pocket expenses, co-payments, percentage payables, preferred providers and other boundaries that are payer driven, maintaining positive customer service attitude when dealing with patients. (20%)
• Identifies and verifies medical benefits and COB order.  Corrects/updates account fields to assure timely, accurate bill submission.  (10%)
• Cooperates with and maintains excellent working relationships with internal and external customers.  Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships. (10%)
• Performs other duties as assigned or required.

QUALIFICATIONS:

Minimum

• Associate's Degree in Billing, Health Care or related field (3 years of coordinator experience/training and/or billing/follow-up experience/training; or equivalent combination of education and experience may be substituted)
• 3 years of performing healthcare registration, patient finance, or customer service.
• 2 years with health insurance terminology and principles
• Customer Service
• Critical thinking
• Problem solving

Preferred

• 1 year in a physician billing or health care claims environment
• Previous experience in interviewing patients and family members
• AAHAM Certified Revenue Cycle Professional

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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