Department: Billing Office Postualte
Reports To: Director and Asst Director of Patient Advocacy & Services
FLSA Status: Non-Exempt
Revision Date: August 2016
The Patient Advocate is responsible for providing effective customer service for all internal and external customers by using excellent in-depth knowledge of the patient’s outstanding balance, resolving patient issues and billing questions as well as communicating effectively with team members within the Patient Advocacy Department.
Essential Duties & Responsibilities
• Ensure delivery of excellent customer service through communication and coordinating with team or other departments to resolve issues.
• Handle incoming calls from patient with questions regarding their statement, EOB’s and/or services received at NEC facilities; process patient refunds, process and review account adjustments.
• Conduct outgoing customer service follow up calls to patients in an effort to ensure that the experience with the facility was positive and pleasant.
• Perform outgoing calls and attempt soft collections on patient’s balances
• Negotiate payment plans according to specified guidelines.
• Responsible for fielding complaints about facility/clinical care, standards as well as HIPAA, red flag rules, and other problems that patients may have. Must record complaints and forward to appropriate manager.
• Follow up with patients to ensure that appropriate changes were made to resolve customers’ complaints or issues.
• Responsible for monitoring and running daily and monthly reports on assigned facilities to ensure balance is due to patient’s in-network Emergency Room benefits and update account status.
• Perform other duties as assigned.
• Demonstrate knowledge of and adhere to regulations and Emergency Center policies and procedures pertaining to safety, emergency preparedness, infection control, OSHA, fire safety and hazardous materials
• Participate in performance improvement activities as necessary
• Maintain confidentiality of patient related issues and adhering to all HIPAA rules and regulations.
• Demonstrate effective interpersonal skills
• Treat all patients, visitors, and staff members fairly and with respect
• Utilize effective communication methods and skills
• Explain all procedures, treatments, and care while remaining aware of language barriers
• Able to perform care in non-judgmental manner and recognize discrepancies between patient and personal beliefs
Emergency Center Policy
• Ensure personal appearance is business casual and professional at all times
• Responsible for wearing Emergency Center identification badge at all times which must be visible and above the waistline
• Attend all required meetings and in-service education
• Remain flexible in staffing patterns and resolution of staffing conflicts; participates in temporary assignments
• Compliance with attendance standards
• Demonstrate flexibility when changes in assignments are necessary
EDUCATION & EXPERIENCE
• High school diploma required
• 3-4 years’ customer service experience a must
• 1-2 years’ experience in medical billing
• Understanding of EOB’s and patient responsibility
• Excellent communication skills with internal and external clients.
• Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization
• Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations
• Basic computer skills
• Professional Maturity: The ability to separate emotional feelings from the real issues at hand
• Responsibility: The ability to accept choices you have made and the results they have led to
• Communication: The ability to write and speak effectively; actively listens to others, and give feedback
• Flexibility: Demonstrate responsiveness and adaptability following change initiatives
• Intelligence: Understand information and apply new knowledge
• Energetic: Exhibits high levels of energy and enthusiasm
• Organized: Efficient in structuring tasks to be accomplished
• Computer Savvy: The ability to use technology efficiently and effectively
• Customer Service: The ability to enhance customer satisfaction
• Job Knowledge/Technical Knowledge: Knowledgeable of current role and technical systems, and the impact it has on the organization
• Integrity and Respect: Demonstrates upmost level of integrity
• Interpersonal Communication: Writes and speaks effectively based on the psychological, relational, situation, environmental and cultural dynamics within the situation
• Collaboration and Partnership: Encourages participation from team members
• Manages Change: Demonstrates flexibility with changing environments
• Problem Solving: Resolve issues in a timely manner
• Attention to Detail: Follows procedures to ensure entry of data
• Organization: Uses time efficiently by prioritizing and planning work activities
• Judgment: Ability to make independent decisions
• Teamwork: Works with others to accomplish objectives and shows support for decisions
• Quality: Sets high standards to ensure quality in work performed
• Accountability: Takes responsibility for adhering to all company policies, procures, and performance expectations
• The physical demands for this position include: adequate vision, hearing, and repetitive motion
• Light physical activity performing non-strenuous daily activities of an administrative nature
• Ascending or descending stairs, ramps and the like, using feet and legs and/or hands and arms
• Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner
• Bending legs downward and forward by bending leg and spine
• Well-lighted, heated and/or air-conditioned indoor office setting with adequate ventilation
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