Patient Advocate II - Hybrid

Promotes favorable company relationships with patients, providers, and payers through prompt, accurate, and courteous resolution of telephone and written inquiries. All new hires must submit to and pass a pre-employment drug screen and background check. Candidates residing in California, Hawaii, or Alaska are not eligible for this role.

Responsibilities

• Answers incoming patient, insurance company, physician office, and facility telephone calls.
• Receives and responds to all inquiries and complaints pertaining to billing, claims, claim denials, payments, and collection activities.
• Records all customer contacts, including resolution or forwarding action taken to refer questions to the proper party.
• Resolves questions directly whenever possible to provide prompt satisfaction to patients.
• Responds promptly to all written inquiries or notifies patients if there will be a delay in resolution.
• Explains account situations accurately in simple language so patients understand the explanation and its application to their questions.
• Works assigned tasks, edits, queues, and correspondence in a timely manner.
• Takes note of recurring questions or problems that may be resolved or alleviated by changes in policy or procedures.
• Attends in-service training to improve skills and stay updated on changes in contracts and procedures.
• Identifies and communicates complaint patterns to the management team.
• Maintains strictest confidentiality and documents all actions in system notes.
• Demonstrates a positive attitude and serves others with personal service 100% of the time.
• Uses the phone responsibly, courteously, and professionally; keeps personal phone calls to a minimum.
• Meets customer satisfaction, productivity, and performance standards set by management.
• Adheres to all company policies and procedures.
• Performs other duties as assigned.

Requirements

• Bilingual (Spanish) preferred.
• Excellent verbal and written English language skills to answer customer concerns in simple, common language.
• Proficiency with math skills (e.g., calculation of charges, payments, and adjustments).
• Knowledge of insurance processing, guidelines, and general laws related to all payers.
• Ability to establish proficiency in using the IDX practice management system.
• Excellent customer service skills.
• Ability to multi-task effectively.
• Data entry skills.
• Basic knowledge of CPT, ICD-9, and ASA codes.
• Sound problem-solving skills and decision-making ability.
• Strong analytical skills.
• Skill in gathering and reporting information from multiple sources (IDX, internet, electronic records).
• Pleasant disposition and high tolerance level.
• Positive “teamwork” attitude and strong interpersonal skills.
• Ability to work effectively and independently.
• Ability to maintain confidentiality.
• Willingness and ability to follow direction and/or company policy as directed by management.

Qualifications

• Minimum 1 year of customer service or billing collections experience.
• High-school graduate or equivalent required.
• Associate degree in health or business administration or related field of study preferred.
• Equivalent combination of education and experience will be considered.
• Experience in a health care organization preferred.

Physical Requirements

• Requires prolonged sitting, some bending, stooping, and stretching.
• Must possess sufficient eye-hand coordination and manual dexterity to operate a keyboard, photocopier, telephone, calculator, and other office equipment.
• Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations.
• Requires lifting papers and boxes weighing up to 35 pounds occasionally.
• Requires dexterity to type at least 50 words per minute.

Working Conditions

• Work performed in an office environment.
• Involves frequent contact with professional staff and managed care organizations.
• Work may be stressful at times.
• Interaction with others is frequent and often disruptive.

Pay

Base pay estimate for this role is $16.49 - $35.14 hourly. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for an annual bonus, awarded based on company and individual performance.