Patient Financial Advocate

The Patient Financial Advocate (PFA) is responsible for ensuring accurate and efficient registrations of patients for medical services. This role is crucial to the hospital's success as it sets the foundation for the revenue cycle by ensuring proper billing and registration. The advocate serves as the first point of contact for patients, welcoming and assisting patients, verifying insurance information, accurately entering patient data, explaining financial policies, answering patient inquiries, and ensuring a smooth registration process for a positive patient experience.

JOB DUTIES

T he position involves ensuring a positive patient experience by greeting and registering patients for medical services such as outpatient procedures or emergency room visits helping patients access the care they need. It is essential to create a welcoming and supportive environment for all patients, fostering trust in the community and ensuring they receive the necessary care.

Advocates ensure that all patients receive and complete necessary forms including HIPAA, consents to treat, Idaho Patient Care Act, and release of information documents. This includes explaining the purpose of each form and answering any questions patients may have. Responsibilities include but are not limited to:

· Have a thorough understanding of various admission types and the necessary forms needed for each visit type. This includes being knowledgeable about the specific requirements for each admission type and ensuring compliance with all necessary documentation.

· This position requires verification of proper demographic information and insurance coverage for patients for accurate and timely billing. You will be responsible for performing verification checks on patient insurance information, contacting insurance companies to confirm coverage details, and updating patient records with accurate information. Additionally, you will work closely with billing departments to ensure that claims are processed correctly.

· As a part of the job duty, you will be responsible for reviewing prescriber orders to ensure all necessary information such as ICD-10, CPT codes, and provider information is present before processing orders and checking in patients. This will ensure proper billing and coding.

· Patient Financial Advocates will print and verify preauthorization document forms, and ensure they are attached to outpatient visits, specifically those related to surgical services or imaging procedures.

· A key job responsibility is to review and verify the medical necessity of requested lab tests for patients covered under Medicare. In cases where additional information or justification is required, it is important to provide Advance Beneficiary Notices (ABNs) to inform patients of potential out-of-pocket costs and obtain their consent before proceeding with testing. This ensures compliance with Medicare guidelines and helps patients make informed decisions about their healthcare.

· You are responsible for completing the consolidated summary of services accurately and thoroughly for patients to ensure compliance with the Idaho Patient Care Act to prevent any instances of surprise billing. This involves documenting all services provided to the patient, including costs and any relevant insurance information, to ensure transparency with third-party billing. A copy must be scanned into the patient's chart for confirmation of delivery.

· As part of the job duty, your responsibility will be to input patients into a tracking board for Lab and Radiology once checked in to ensure that they are visible and ready to be seen by the respective medical professionals.

· In addition, you will be responsible for answering phone calls when not assisting a patient and directing patients to the correct departments for their needs.

· You will also be responsible for reviewing incoming faxes and scanning orders into designated public drive folders for proper documentation and storage.

· Ability to effectively communicate with hospital staff, including nurses and doctors, to address registration needs and ensure proper patient care. This involves understanding and responding to their requests promptly, coordinating necessary information for registration, and facilitating a smooth process to optimize patient outcomes.

· As part of the job, you may be required to assist patients in getting in and out of their cars and help with wheelchairs as needed. This may involve providing physical support, guiding patients safely, and ensuring their comfort and safety during transport.

· Capable of ensuring all surgical packets and outpatient procedure packets are accurately assembled and completed in a timely manner for upcoming procedures.

· Be able to collect incoming mail, sort it accordingly, and complete the daily deposit for any checks received in the mail for billing.

· Be able to courier between clinics and transport items as assigned, ensuring timely delivery and accurate documentation of all items.

· Answering and logging billing calls in a spreadsheet for billing review. This includes accurately recording all relevant information from the call and ensuring that it is documented appropriately for further review and processing.

· Responsible for managing the petty cash box by maintaining its balance through daily counting of cash, ensuring accuracy and accountability in all transactions.

· Ensure the reconciliation of daily payments in Athena to facilitate the time-of-service reconciliation process. Keep detailed records and utilize Athena's tools effectively to accurately match payments with services rendered daily.

· As part of this role, the employee will be required to enroll in HMFA Patient Access and Revenue Cycle courses and complete training programs as part of their ongoing professional development. This will ensure that they stay up to date with the latest industry standards and best practices, allowing them to excel in their position and contribute effectively to the organization.