Benefit Advocate Ontario Full-Time Days
Company: Trinity Health
Location: Ontario
Posted on: April 28, 2024
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Job Description:
Employment Type:
Full time
Shift:
Day Shift
Description:
At Saint Alphonsus Health System, we are looking for people who are
living out their calling. We want you to be passionate about coming
to work, and challenged to achieve your potential. Living by these
virtues, we pride ourselves on exceptional service and the highest
quality of care.
POSITION PURPOSE:
The Patient Benefit Advocate I is responsible for coordinating
payment sources and other activities related to securing
reimbursement for hospital services rendered to patients who are
either already admitted to our hospital or who may be seeking to
obtain services. The Patient Benefit Advocate I will educate and
assist patients with understanding their insurance options, setting
up payment arrangements, and collecting patient financial
responsibilities, while also assisting with any and all avenues of
financial assistance available to them. The Patient Benefit
Advocate I will perform all functions in a courteous and respectful
manner, advocating for the patient's best interest and
wellbeing.
SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:
High school diploma or an equivalent combination of education and
experience. Associate degree in Accounting or Business
Administration highly desired.
Past work experience of at least two to three (2-3) years within a
hospital or clinic environment, a health insurance company, managed
care organization or other health care financial service setting,
performing medical claims processing, financial counseling,
financial clearance, accounting, or customer service activities is
preferred.
Working knowledge of medical terminology, anatomy and physiology,
and medical record coding (ICD-10, CPT, HCPCS) is preferable.
Completion of regulatory/mandatory certifications and skills
validation competencies preferred.
Notary public credentials preferred.
ESSENTIAL FUNCTIONS:
Knows, understands, incorporates, and demonstrates the Trinity
Health Mission, Core Values, and Vision in behaviors, practices,
policies and decisions.
Works with vendors and patients in applying for routine insurance
coverage.
Develops positive relationships with vendors and hospital
personnel.
Educates patients on routine insurance coverage and financial
assistance options, when appropriate. Assists with application
process for patient coverage.
Calculates and provides patient pricing estimates for services upon
request of patient.
Refers patients to patient loan programs as necessary.
Collects any patient liabilities due and performs routine
cashiering functions.
Identifies routine issues and either resolves or escalates to Lead
Patient Benefit Advocate to resolve.
Works with contracted vendors/agencies to qualify applicants for
insurance coverage, reviewing each case prior to agency placement.
Provides pricing estimates and communicates pre-service patient
liability based on expected charges and potential coverage.
Performs benefit advocacy functions for patients on a pre-service,
point of service and post-service basis.
Interviews patients and/or their representatives, by adapting and
utilizing interviewing techniques to meet respective needs,
educational levels, and abilities of the interviewee, to accurately
update demographic, clinical, financial and insurance data
necessary to complete the benefit advocacy process and screen
patients for financial assistance.
Reviews prior account notes for past due balances and any
information that might aid in the application/payment process and
documents all encounters and actions.
Informs patients/guarantors of their liabilities and collects
appropriate patient liabilities, including co-payments,
co-insurances, deductibles, deposits and outstanding balances at
the point of contact. Utilizes available tools to calculate patient
liabilities.
Interacts and collaborates with numerous departments to resolve
issues while also analyzing necessary information that will ensure
hospital reimbursement.
Initiates requests for charity write-offs, when appropriate.
Monitors accounts in the self-pay or eligibility pending financial
class and following up to provide account resolution.
Interprets data, draws conclusions, and reviews findings with Lead
Patient Benefit Advocate for further review.
Takes initiative to continuously learn all aspects of Patient
Benefit Advocate role to support progressive responsibility.
Other duties as needed and assigned by the manager.
Maintains a working knowledge of applicable Federal, State, and
local laws and regulations, Trinity Health's Organizational
Integrity Program, Standards of Conduct, as well as other policies
and procedures to ensure adherence in a manner that reflects
honest, ethical, and professional behavior.
Knowledge of insurance and governmental programs, regulations and
billing processes e.g., Medicare, Medicaid, Social Security
Disability, Champus, Supplemental Security Income Disability, etc.,
managed care contracts and coordination of benefits is highly
desired.
Colleagues of Saint Alphonsus Health System enjoy competitive
compensation with a full benefits package and opportunity for
growth throughout SAHS and Trinity Health!
Visit www.saintalphonsus.org/careers to learn more about the
benefits, culture, and career development opportunities available
to you at Saint Alphonsus Health System.
Visit Saint Alphonsus on LinkedIn
(https://www.linkedin.com/company/saint-alphonsus-health-system/) ,
Facebook (https://www.facebook.com/SaintAlphonsus/) , Instagram
(https://instagram.com/saintalphonsus?utm_source=ig_profile_share&igshid=1ecujfk63xezr)
, YouTube
(https://www.youtube.com/channel/UCFgYXHlHzYPLDjozyU03WGA) , and
Twitter (https://twitter.com/SaintAlsHealth) !
Saint Alphonsus and Trinity Health are committed to promoting
diversity in its workforce and to providing an inclusive work
environment where everyone is treated with fairness, dignity and
respect. We are committed to recruit and retain a diverse staff
reflective of the communities we serve. Saint Alphonsus and Trinity
Health are equal opportunity employers and prohibit discrimination
against any individual with regard to race, color, religion,
gender, marital status, national origin, age, disability, sexual
orientation, or any other characteristic protected by law.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic
healthcare systems in the nation. Built on the foundation of our
Mission and Core Values, we integrate diversity, equity, and
inclusion in all that we do. Our colleagues have different lived
experiences, customs, abilities, and talents. Together, we become
our best selves. A diverse and inclusive workforce provides the
most accessible and equitable care for those we serve. Trinity
Health is an Equal Opportunity Employer. All qualified applicants
will receive consideration for employment without regard to race,
color, religion, sex, sexual orientation, gender identity, national
origin, disability, status as a protected veteran, or any other
status protected by law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000
physicians and clinicians across 25 states. Because we serve
diverse populations, our colleagues are trained to recognize the
cultural beliefs, values, traditions, language preferences, and
health practices of the communities that we serve and to apply that
knowledge to produce positive health outcomes. We also recognize
that each of us has a different way of thinking and perceiving our
world and that these differences often lead to innovative
solutions.
Our dedication to diversity includes a unified workforce (through
training and education, recruitment, retention, and development),
commitment and accountability, communication, community
partnerships, and supplier diversity.
EOE including disability/veteran
Keywords: Trinity Health, Caldwell , Benefit Advocate Ontario Full-Time Days, Other , Ontario, Idaho
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