Care Management - Financial Advocate

Position Summary

The Care Management - Financial Advocate helps patients navigate the financial aspects of healthcare by ensuring they understand medical bills, insurance coverage, and financial assistance options. This role also involves pretreatment and post-treatment negotiations, as well as supporting patients through billing disputes and appeals processes.

Duties and Responsibilities

• Insurance & Claims Support
  • Explain health insurance policies, benefits, deductibles, copays, coinsurance, and indemnity reimbursements.
  • Develop individual financial action plans and follow up on progress towards financial goals.
  • Provide financial guidance and advocacy to clients regarding available financial assistance programs, benefits, and resources.
  • Ensure claims are processed accurately and help resolve issues with insurers.
• Billing & Payment Assistance
  • Review and explain medical bills to identify errors or overcharges.
  • Negotiate payment plans, discounts, or settlements with healthcare providers.
  • Support patients with pretreatment and posttreatment financial arrangements.
• Financial Counseling & Resources
  • Assess patients' financial situations to recommend appropriate payment options.
  • Connect patients with financial assistance programs, charity care, or government subsidies.
  • Educate patients on managing healthcare expenses and available support resources.
• Patient Advocacy & Support
  • Represent patients in disputes with providers or insurers regarding billing or coverage.
  • Ability to maintain confidentiality and handle sensitive patient information in compliance with HIPAA Regulations.
  • Provide compassionate support during financially stressful situations.

Qualifications and Skills

Required:

• Minimum 3 years of experience in healthcare financial counseling, billing, or claims.
• Strong knowledge of private insurance, Medicare, Medicaid, and payer systems.
• Ability to interpret medical bills, EOBs, and resolve billing discrepancies.
• Familiarity with financial assistance programs and subsidies.
• Proficiency with EHRs, insurance systems, telehealth platforms, and CRM tools.
• Excellent written and verbal communication skills.
• Strong analytical and problemsolving abilities.
• Must be legally authorized to work in the United States.
• Ability to successfully pass a background check.

Preferred:

• Associate's degree in healthcare administration, finance, or related field.
• Experience in patient advocacy or hospital financial services.

Education

High School diploma or equivalent (GED)

Work Environment

• Professional office environment with standard hours (Mon-Fri, 8am-5pm); occasional extended hours during peak times.
• Frequent use of computer, phone, and standard office equipment.
• Regular interaction with staff, leadership, and customers in a fast-paced, high-volume setting.
• Occasional standing, walking, and lifting of up to 15 pounds (e.g., supplies or equipment).