Patient Financial Advocate, Full Time- Day Shift

The following information is designed to outline the functions and position requirements of this job. It does not identify all tasks that may be expected, nor address the performance standards that must be maintained.

General Position Summary:

The Patient Financial Advocate is responsible for assisting patients and/or families to access financial resources. The assists with guidance to those patients who may qualify for assistance through state, county, and federal programs. The Advocate is also available to patients and families to answer questions regarding their insurance give estimates of co-pay amounts, and to aid patients in obtaining prior authorizations for services.

Essential Functions / Major Responsibilities:

·         Assist appropriate patients and families to explore options for financial assistance for medical services with referral to Social Services when appropriate.

·         Follow up with appropriate patients and families for financial assistance needs.  Assist with pharmacy grants, copay assistance and pharmaceutical programs.

·         Obtain necessary insurance information for patients. Answer questions or directs patients to appropriate staff members for questions regarding insurance, billing, payment, and/or collection arrangements.

·         Meet with patients to discuss estimated costs of therapies.

·         Work closely with patients and Patient Financial Services (PFS) to resolve account balance issues and establish payment plans.

·         Develop appropriate templates of charges by care regimen to assist patients.

·         Obtain authorization for or thru specialty pharmacy referral and financial assistance for oral chemotherapy medications.

·         Complete Disability, FMLA and Medical Necessity forms to assist patients.

·         Perform other duties and responsibilities as assigned. accc-cancer.org/fantoolkit

PROFESSIONAL COMMUNICATION

·         Maintain confidentiality in matters relating to patient and family.

·         Interact with patients and families with a variety of developmental and sociocultural backgrounds.

·         Provide information to patients and families to reduce anxiety and convey an attitude of acceptance, sensitivity, and caring.

·         Maintain professional relationships and convey relevant information to other members of the healthcare team within facility and any applicable referral agencies.

·         Initiate communication with peers about priorities.

·         Relay information appropriately over telephone, pagers, and other communication devices. 

TEAMWORK

·         Accept assignments based on workload, priorities, and the qualifications and competencies of self and of other staff members.

·         Work closely with other staff, coworkers, peers, and other members of the healthcare team to ensure a positive and effective work environment.

·         Report to appropriate personnel regarding assignments and projects.

·          Initiate problem-solving and conflict resolution skills to foster effective work relationships with peers. 5. Report to work on time and as scheduled. 

PROFESSIONAL DEVELOPMENT

·         Attend staff meetings, in-services, and continuing education.

·         Contribute to annual reviews of peer performance as requested by the unit or area supervisor, manager, or director.

·         Assist in the development of indicators, thresholds, study methods, and data collection as assigned.

·         Respond to problems and opportunities to improve care and customer service.

·         Support involvement in the hospital’s Performance Improvement (PI) initiatives.

·         Participate in and maintain competencies required for the position and specific unit or area(s) of assignment. 

Secondary Functions:

Participates in departmental and hospitalwide informational meetings and inservices, including staff meetings, hospitalwide forums, and seminars.

·         Reviews department and hospitalwide policies and procedures annually.

·         All other duties as assigned.

Additional Responsibilities:

·         None. 

Job Scope:

This job involves:

·         A Wide diversity of work situations.

·         A high level of complexity.

·  Operation from established and well-known procedures. Contributes to the development of new services, programs, or processes.

·       Performance of duties under independently-minimal supervision.

Supervisory Responsibility:

·         None.

Interpersonal Contacts:

Contacts:

·         Are normally made with others both inside and outside the hospital.

·       Are usually made with own department staff and supervisor as well as with other departments or locations.

·        Frequently contain confidential/sensitive information necessitating discretion at all times.

·         Are usually face-to-face, with some contact by telephone and e-mail.

·         Are usually with patients, staff, and physicians.

Specific Job Skills & Mental Activities:

This position requires a working knowledge of various clinical, financial, operational, and satisfaction functions. This employee must be service-oriented and have excellent communication, critical thinking, problem solving, leadership skills, professional interpersonal skills, independent judgment skills, basic math skills, computer skills, multitasking skills, and time management skills. This position also requires knowledge of the Hospital Information Systems and department specific equipment. Must be able to read, write, speak, and understand English, as well as the following skills;

·         Experience in Medications/ pharmacy related field and medical terminology

·   Ability and willingness to exhibit behaviors consistent with standards for performance improvement and organizational values (e.g., efficiency and financial responsibility; safety; partnership and service; teamwork; compassion; integrity; and trust and respect).

·      Ability and willingness to exhibit behaviors consistent with principles for service excellence.

·         Awareness of philosophy of care as it relates to Patient Financial Services.

·   Demonstrate knowledge of current resources and programs to assist the patient’s need for financial resources.

·        Demonstrates ability to act with sensitivity as a patient advocate.

·       Demonstrates interview skills and clearly defines the problems and concerns to patients and family systems as related to medically-related financial

Education, Licensures, and/or Experience:

·         High school diploma or equivalent (required).

·         Basic computer skills (required).

·         Minimum of two years’ experience in health related agency or completion of field placement in healthcare setting.

·         Nursing experience in critical care (preferred).

·         2 years of medical terminology or pharmacology experience (preferred).

Physical Demands & Job Conditions:

Exert up to 50 lbs. of force occasionally, and/or up to 20 lbs. of force frequently, and/or up to 10 lbs. of force constantly to move objects. The worker is exposed to contact with chemicals and infectious fluids, heavy lifting, constant standing, on-call status, and encounters with upset/disturbed individuals.

Physical motions include finger dexterity, standing, walking, stooping, crawling, talking, reaching, feeling, sitting, bending, kneeling, climbing, grasping, listening/hearing, handling, lifting up to 20-50 pounds, and repetitive motions of the hands, wrists, and feet.

•         This is a safety sensitive position 

OSHA Exposure Category:

Involves exposure to blood, body fluids, or tissues.