Patient Financial Advocate

SUMMARY:

Under general supervision and working exclusively within the premises of the hospital, to serve as a liaison between the hospital, patients and family members to ascertain, develop and secure resources which may be available to patient and family members for the resolution of medical expenses incurred. Pre-admit all Self-Pay in and Outpatients and arrange payment terms for services as circumstances warrant.
Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

Instill Trust and Value Differences
Patient and Community Focus and Collaborate

RESPONSIBILITIES:

* Identify and assist patients and family members who are insured with limited financial resources to make medical necessary health care services more affordable to those patients who do not qualify for government sponsor insurance programs such as Medicaid or insurance exchange programs.

* The Patient Financial Assistance (PFA) team reviews all self-pay patients listed in the financial assistance work queue and proactively identifies individuals who may qualify for support. The team also receives and processes referrals from patient registration staff for patients who may benefit from financial assistance programs.

* When patients or family members are eligible, connect them with appropriate resources to help cover medical expenses. If the patient does not qualify for available programs, the advocate will, within hospital policies and procedures, assist with completing and submitting financial assistance applications.

* Self-pay ED, direct admissions for inpatient or observation services are the responsibility of the Patient Financial Advocate. The advocate verifies demographic information, prepares and assembles all required documentation for State Medicaid, financial assistance or establishes financial arrangements with patients and their family members.

* Develop and maintain databases of available medical financial resources and benefit programs that may serve patients. Establish and maintain contacts and relationships within the healthcare and human services community to support patients, their family members, and the hospital.

* Establish intra-departmental contacts to foster cooperative relationships of mutual benefit, with specific emphasis on developing effective communication with Social Services, Clinical Managers, Medical Staff, and the Registration Department.

* Reestablish account balances that were written off to financial assistance when alternative coverage, such as Medicaid, is subsequently identified, or when the account becomes eligible for Newport Hospital funds, if applicable.

* Prepare and maintain monthly productivity reports and financial assistance statistics as required by management. Prior to service, contact all uninsured patients to verify demographic information, establish payment arrangements, and screen for eligibility in state Medicaid programs. May also review payment requirements with referred insured patients who are unable to meet their financial obligations, including previously incurred hospital balances.

* Review and interview self-pay patients prior to discharge, as required by policy, to ensure they are financially cleared at the time of discharge or release. Establish payment arrangements as circumstances warrant. Contact the referring physician or department to determine the urgency of services when a patient is unable or unwilling to make payment.

* Discuss payment plans with all self-pay direct and ED admissions.

MINIMUM QUALIFICATIONS:

BASIC KNOWLEDGE:

A level of knowledge generally obtained through High School. Good verbal and written communication skills. Computer skills.

Ability to communicate with patients and family members with empathy while at the same time retain a professional relationship.

Has knowledge of forms, documents, incomes set regulatory parameters involved with the establishment of eligibility for financial resources and benefits available to qualifying patients and family members.

Know and understand United States Immigration Laws, including the rights, benefits and limitations affecting individuals through their alien status.

Have knowledge and familiarity with credit resources, finance plans, terminology, documents and hospital policy regarding their utilization.

Have knowledge and skills concerning use a Personal Computer including use of hospital systems, preparation of reports and correspondence as well as to be able to use and access e-mail and the internet.

Have knowledge of medical terms and conditions that may support the establishment of patient eligibility for medical benefits.

Have knowledge of regulations concerning patient personal confidentiality (HIPAA).

EXPERIENCE:

Two years in a hospital environment with involvement in experience with third party payer coverage. Computer skills required.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Working conditions are generally good; there is some exposure to the normal patient care environment as some patient interviews are conducted with patients at the Nursing Units.

SUPERVISORY RESPONSIBILITY:

None

Pay Range:

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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Driving Required: