Patient Continuity and Needs Advocate

About the role

The Patient Continuity and Needs Advocate (PCNA) supports eligible patients and their families in receiving Medicaid and Federal resources that adhere to State and Federal policies. Key responsibilities include supporting Medicaid enrollment, sharing opportunities to maximize medical benefits, arranging follow-up appointments, and maintaining patient information in an Electronic Medical Records (EMR) system.

Responsibilities

• Supports Medicaid enrollment; collects demographic documentation and financial data and initiates follow-up procedures when necessary.
• Identifies and shares opportunities to maximize medical benefits and, when necessary, arranges follow-up appointments to ensure appropriate guidance to health services and application timelines.
• Utilizes an Electronic Medical Records (EMR) system to gather and store patient information, respond to questions on behalf of the patient, and appropriately and timely document patient issues and resolutions.
• Maintains assigned work queue of patient accounts.
• Completes relevant patient documentation in compliance with all regulatory agencies, including HIPAA.
• Performs other duties as assigned and modified at manager’s discretion.

Requirements

• High School diploma or GED equivalent required; BA/BS degree preferred.
• A minimum of three (3) years’ work experience required; working with seniors a plus as is a general understanding of Medicare Advantage.

Qualifications

• Dependable and time-conscious.
• Flexibility, agility, self-starter, comfortable with frequent changes and innovations.
• Competent level business acuity.
• In-depth knowledge and understanding of general/core job-related functions, practices, processes, procedures, techniques and methods.
• Understanding of member attribution, eligibility and the disenrollment process.
• Demonstrated skill in customer service and service recovery.
• Knowledge of and experience in working with insurance brokers or agents preferred.
• Detail-oriented with proficiency in Salesforce.
• Strong written and verbal communication skills.
• Positive attitude and the ability to build trust with internal and external partners.
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
• Spoken and written fluency in English.

Skills

• Builds and maintains exceptional customer service relationships with healthcare services agencies, patients, providers and peers.
• Knowledge and understanding of local, state and federal healthcare benefit services and plans.
• Business acumen and understanding of member attribution, eligibility and the disenrollment process.
• Customer service and service recovery skills.
• Experience in working with insurance brokers or agents.
• Detail-oriented with proficiency in Salesforce.
• Strong written and verbal communication skills.

Benefits

We offer a competitive pay range of $17.0 - $24.26 hourly, with final compensation depending on a variety of factors including experience, education, and other relevant factors. This position may also be eligible for bonuses or commissions. Employee benefits include:

• Comprehensive benefits package.
• Career development and advancement opportunities.
• Great work-life balance.

Join our team who make a difference in people’s lives every single day.