Patient Advocate II

Summary:

The Patient Advocate II is crucial in managing patient communications related to billing and insurance queries. This role involves efficiently handling both inbound and outbound calls, providing accurate self-pay price quotes and estimates, and promptly resolving patient inquiries through informed decisions and coordinated efforts. Building on the foundational responsibilities of the Patient Advocate I’s position; this role requires advanced skillsets to deliver enhanced service and support to our patients.

This position sits in our corporate office in Melville, New York.

Duties:

Inbound and Outbound Communication

• Efficiently manage inbound and outbound calls, ensuring high-quality service and responsiveness to patient needs.

Issue Analysis and Resolution

• Analyze Explanation of Benefits (EOB) documents to understand and resolve billing issues.

• Utilize critical thinking and problem-solving skills to address and resolve patient inquiries quickly.

• Effective Communication: Provide clear explanations to patients regarding their insurance claims and coverage. Identify and escalate complex issues to the correct department for timely resolution.

Financial Reviews and Adjustments

• Self Pay Credit Balance Review: Ensure accounts have been reviewed and worked on for outstanding balances.

• Adjustment posting: Post adjustments after accounts have been reviewed and deemed necessary.

• Collection Review: Remove accounts from collections upon review.

• Collection Agency Reports: Review reports daily.

• Bankruptcy Reviews: Conduct reviews of accounts to ensure the final financial status of bankruptcy is valid.

• Price Quotes and Estimates: Deliver accurate and prompt self-pay price quotes and financial estimates to patients, enabling them to make informed decisions regarding their care.

Workqueue Reviews

• Bad Address Review: Review statement edits in Self Pay Open Workqueue in Athena to ensure accounts have been appropriately worked in conjunction with the billing cycle.

• Correspondence Open Task Workqueue: Review accounts in Athena to ensure proper assignment and follow-up.

• Self Pay Open Workqueue: Review statement edits, debit statement balance, credit account balance, and invalid statement totals.

• Hold Bill/Alert Open Workqueue: Review accounts that need to be worked due to incomplete registrations.

QUALIFICATIONS:

• Proven experience in customer service, preferably in a healthcare or financial setting.

• Strong understanding of medical billing processes and insurance-related documentation.

• Excellent communication and interpersonal skills.

• Ability to work effectively both independently and as part of a team.