Sanford Health

Financial Advocate - Patient Access Management

Location
Sioux Falls, South Dakota
Salary
Join our team!
Posted
Aug 07, 2018
Ref
21279
Role
Accountant
Job Type
Long-Term
Job Title: Financial Advocate | Patient Access Management | Sioux Falls

City: Sioux Falls

State: South Dakota

Department *: * PATIENT ACCESS MANAGEMENT

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

JOB SUMMARY

Provides financial advocacy counseling to patients/families including topics of insurance coverage, treatment coverage, prompt pay and financial hardship discounts to patients and family members. Responsible for screening self-pay patients and evaluate them to determine eligibility in various governmental and non-governmental programs to ensure patients are assisted in meeting their financial obligations. Discuss agreeable payment plans with qualified patients. Responsible for identifying all sources of potential payors including Commercial Insurance, Private Insurance, etc. Also responsible for providing and completing the Financial Assistance Application form and assisting patients in the process of applying for any benefits for which they may be eligible. Determine patient eligibility for assistance programs through interviews and screening processes. Complete an insurance benefit investigation for all new/transferring patients as appropriate. Completes prior authorization as necessary. Works with patients to ensure continued eligibility and ensure re-certifications. Contacts appropriate agencies to obtain information and paperwork necessary to process patient's assistance applications. These resources can include state caseworkers, banks, employers, Social Security Administration, medical facilities, and insurance companies. Assist with patient assistance programs offered by pharmaceutical companies, state governments and nonprofit groups. Educates patients on various sponsorship programs available based on eligibility including but not limited to Medicare, Supplemental Security Income, Social Security Disability, Medicaid programs, County eligibility, and Indian Health Services. Assist with completing FMLA and Disability paperwork requirements. Assist patients to navigate the Medicare System to ensure benefit start dates are accurate, correct insurance is primary, ESRD benefits, etc. Ensures avenues of reimbursement or assistance are pursued for uninsured and underinsured patients. Refers patients to other agencies for assistance when needed and discusses the financial statement process relating to payment options and hospital assistance, including grants. Follows up in obtaining missing insurance information, patient demographics, etc., on patient accounts for the proper handling in the billing office. Complete price estimates. Completes annual review of insurance pamphlet and coverage options as mandated by Conditions for Coverage. Communicates with supervisor and various departments such as Nursing, Physicians, Case Management, Social Work, Patient Access, Patient Relations, Quality Resource Management and Social Services to address patient concerns. Complies with other job-related responsibilities as directed by Leadership. Demonstrates a caring and respectful attitude to all patients, family members, visitors and fellow employees as defined in the mission and values of the organization.

DEPARTMENT DETAILS

Delivers written and oral communication, responds to questions and concerns, and produce specific outcomes and impact. Proposes alternative solutions when presented with problems or opportunities. Maintains a sense of urgency and a positive attitude. Provides a quality of service that customers describe as excellent. Establishes and maintains productive working relationships within and outside of own area. Develops trust and credibility by acting in a consistent, genuine manner.

QUALIFICATIONS

Bachelors degree in social work, case management, public relations or related field required. Previous experience in healthcare serves or health insurance would be beneficial, but not required.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing.
Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.
In addition to strong clinical care, we are also committed to research, education and community growth.
We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.
We continuously seek new ways to achieve our vision of improving the human condition here in your community,
across the region and around the world.
The entire team at Sanford Health recognizes the value of healthy families and communities.
We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application,
please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .
In compliance with federal law requiring employers to verify new employees' U.S.
employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf .

City: Sioux Falls

State: South Dakota

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: req21279

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