Financial Advocate - BUSINESS OFFICE

Type of Opportunity: Full Time

FTE: 1

Exempt: No

Work Schedule: Days

Location: Presbyterian Espanola Hospital

We're all about well-being, starting with yours.

Presbyterian is committed to an inclusive and equitable environment where everyone is valued and empowered for success. We believe that our environment should reflect the diversity of our community.

How you grow, learn, and thrive matters here.

Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Strongline Staff Safety (a wearable badge that allows you to quickly and discreetly call for help when safety is a concern)
• Shift differentials for nights and weekends
• Differentials for higher education, certifications, and various lead roles
• Malpractice liability insurance

As a Financial Advocate in the Business Office you'll perform financial screening on hospital and medical group account activity to identify residual balances, high-deductible plan participants and self-pay patients. Requires thorough knowledge of assistance programs to include charity care application, Medicaid (PEMOSSA) application and other alternate resource programs in addition to full competency of Presbyterians policy for payment plan application.

• High School (G.E.D.) required.
• Three to five years of experience in healthcare field with significant MD and patient interaction required. Physician office or hospital experience preferred.
• Prior billing office and collection experience preferred.
• Must be able to demonstrate competency in registration with the ability to pass all Epic competencies within 30 days of hire. Requires detailed knowledge of operations in a medical practice in terms of what and how work is to be done as well as why it is done, this level includes interpretations of data.
• Proficient in ICD-9 Medical Terminology and CPT. Basic excel experience preferred for reporting requirements. Demonstrated ability to communicate effectively and work cooperatively with the public as well as all levels of staff and management

• Calculate patient out of pocket expectation (co-insurance, co-payment, deductible, residual amounts) and alert patient to that balance prior to upcoming visit. Use coding knowledge to calculate charges for more complicated levels of service (modifiers, lesions, etc). Contact patient to set the expectation for payment during the visit. Offer an appointment to review account when questions exist.
  
  
• Successful collection rate of residual, high-deductible and self pay amounts in a courteous, professional manner using CARES Behaviors.
  
  
• Exceptional registration accuracy skills to identify errors and correct them as necessary. Serves as a resource to staff regarding account interpretations. Identify claims where filing errors have occurred and resubmit the claims to payors for consideration.
  
  
• Demonstrated competence in using patient estimator technology and on line tools available to provide a reasonably accurate out of pocket expense expectation for patients and their guarantors.
  
  
• Facilitates the operations of the clinic or hospital by providing support to clerical staff to discuss account activity with patients and guarantors. Communicates appropriate situations to Clinic Manager , DPO, and Patient Access Supervisor.
  
  
• Keeps current on PHS financial policies, including payment plans, programs and other forms of funding.
  
  
• Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope.

Learn more about our employee benefits.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees.

Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.