Financial Services Advocate

Candidates should reside in Pennsylvania. This role is remote based with weekly travel to clinics in the Pennsylvania area and 2 in NYC metro area.

About the role

The Financial Services Advocate (FSA) supports insurance retention by providing direct patient education and collaborating with Social Workers and other center staff as needed to identify insurance options related to dialysis across multiple markets. The FSA focuses on all health insurance types, including Commercial, Supplemental, and Government-sponsored plans, such as Medicare, Medicare Advantage, and Medicaid plans. This role carries out a range of educational, administrative, and reporting responsibilities to support corporate and regional teams while empowering patients to make informed decisions that align with their needs. The FSA takes a proactive approach to helping patients understand their benefits, delivering clear education, and minimizing coverage lapses.

Responsibilities

• Deliver proactive patient education to improve understanding of benefits and reduce lapses in insurance coverage.
• Educate new patients with out-of-network (OON) benefits in accordance with the No Surprises Act to support informed decision-making.
• Complete an initial pre-assessment screening for new patients, identifying education needs and insurance coverage opportunities upon admission, or soon thereafter.
• Document all patient interactions in designated tracking system and complete assigned work list items timely.
• Support patients through life events that may impact their coverage choices (e.g., COBRA and transitioning to Medicare due to COB).
• Assist underfunded and unfunded patients by providing enrollment assistance, education, and referring to brokers when applicable.
• Submit actionable, detailed red flag insurance verification request for intake to verify insurance coverage and accurately update PEARL insurance coverage records.
• Assist with insurance reinstatements as needed, including member appeals.
• Provide ongoing education and coordination regarding Medicaid and Medicare applications and renewal processes.
• Play a key role in open enrollment initiatives by educating patients on their choices, as well as educating clinics and reporting findings.
• Seek out and establish strong alliances with local brokers and insurance agents.
• Take an active role in helping support patients eligible for charitable premium assistance.
• Engage in various financial assistance programs and special projects (internal or external) and partner with Social Workers through these processes.
• Participate in facility Operation meetings and present potential risks related to loss of insurance coverage.
• Travel is required; arrange in-person scheduled meetings at clinics within driving distance at least quarterly. Remote outreach for out-of-state markets is acceptable, but use electronic meeting tools and travel to clinics in between visits.
• Stay informed of industry changes and share this information with department management.
• Develop and maintain relationships through effective and timely communication.
• Protect confidential information, always maintaining strict confidentiality.
• Promote GUEST customer service standards and build effective working relationships across all levels of the organization.
• Support a team-oriented environment and perform duties in accordance with company policies and procedures.
• Work to meet individual and team metrics and goals as outlined by management.
• Escalate coverage risks immediately and collaborate to resolve quickly.
• Maintain regular and reliable attendance.

Requirements

• High school diploma or equivalent.
• 2+ years of experience in a healthcare setting and prior customer service experience.
• Bi-lingual language skills are a plus.
• Thorough understanding of ESRD billing and COB rules.
• Ability to multi-task, prioritize, and work independently.
• Able to develop and present training materials when necessary.
• Exceptional communication skills.
• Intermediate working knowledge of Microsoft Outlook, Word, Excel, TEAMS.
• Travel will be required as part of this position.

Benefits

All Full Time employees are eligible for the following benefits:

• Medical / Pharmacy
• Dental
• Vision
• Voluntary benefits
• 401k with employer match
• Virtual Care
• Life Insurance
• PTO

All Part Time employees are eligible for the following benefits:

• 401k with employer match
• PTO