Pre-Access Advocate

About the role

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. Our culture, known as The Meaning of Care, sets us apart by helping families grow through special deliveries, offering compassionate care for difficult diagnoses, exceeding patient needs, and celebrating personal health victories.

Responsibilities

• Serve as an advocate for new patients to Methodist Physicians Clinic.
• Create patient estimates and speak directly with each patient to review estimated cost of care and payment policies.
• Afford assistance with FMLA, Disability, or other forms in a timely manner.
• Verify benefits and obtain authorizations using electronic sources to improve efficiency in obtaining authorizations, ensuring timely care is provided.
• Document medical necessity checking outcomes and generate waiver/Advanced Beneficiary Notice (ABN) if medical necessity checking does not meet payer criteria, patient is seeking care for a non-covered benefit, or a self-pay patient.
• Assist, counsel, and suggest problem-solving techniques to patients as they relate to prompt payment of accounts by following department policies to ensure timely resolution of account issues.
• Process paperwork by reviewing accounts that have filed bankruptcy and forwarding them to the immediate supervisor for adjustment.
• Assist patients with community resources when needed, assist with drug company financial assistance for patients, and manage Every Women Matters initiatives.
• Manage patient accounts, document financial arrangements, insurance coverage, special instructions from physicians, and other pertinent information needed to ensure proper handling of the account.
• Verify insurance or determine if self-pay, set up accounts and payment plans, monitor payments, and complete work associated with insurance changes during the day.
• Prepare daily deposits and daily return mail, open safe in the morning and distribute bags, secure bags at the end of the day in the safe, and prepare daily deposit for pickup.
• Review daily return mail by checking the status of accounts on the computer and determining any actions to be taken using appropriate skip tracing techniques to facilitate timely billing of patients.
• Maintain patient confidentiality within the area by following office procedures to ensure all information is correct.
• Communicate effectively with other department personnel, nurses, physicians, attorneys, insurance companies, and all other parties, by phone or mail, to maintain professional handling of all situations in relation to patients' accounts.

Requirements

• High school diploma or General Educational Development (GED) required.
• Post-secondary education in a healthcare field (e.g., CNA, CMA, etc.) preferred.
• Two years of healthcare experience required, including electronic medical record (EMR) experience.
• Registration, insurance, or prior-authorization experience preferred.
• OB/GYN office experience preferred.

Skills/Knowledge/Abilities

• Knowledge of Current Procedural Terminology (CPT) and International Classification of Disease (ICD) codes.
• Skilled in using computers and office equipment.
• Organized and prioritizes work.
• Knowledge of Insurance billing, payment collection practice and revenue cycle, preferred.
• Extensive customer contact.
• Skilled in time management.
• Skilled in oral and written communication.
• Ability to work under limited supervision and stressful conditions.
• Ability to adhere to all workplace and safety requirements, regulations, standards, and practices.
• Ability to travel to rotating work sites.

Physical Requirements

• Weight Demands: Light Work - Exerting up to 20 pounds of force.
• Physical Activity: Not necessary for the position (0%).
• Frequent Activities: Distinguish colors, fingering/Touching, grasping, keyboarding/typing, reaching, repetitive motions, sitting, speaking/talking.
• Constant Activities: Hearing, seeing/Visual.

About Nebraska Methodist Health System

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. Since Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Employer Information

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.