Financial Advocate – PA/PFS – Maitland — 246779
Job Category: Professional – Non Clinical
Location: Maitland, FL
Financial Advocate – Patient Financial Services – Maitland
Florida Hospital seeks to hire a Financial Advocate who will embrace our mission to extend the healing ministry of Christ.
Established in 1908, Florida Hospital is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The 2,286-bed acute-care medical facility, comprised of eight hospitals, has been recognized by U.S. News & World Report as one of the best hospitals in the country for the past 10 years. It serves as a community hospital for Greater Orlando and as a major tertiary referral hospital for Central Florida and much of the Southeast, the Caribbean and Latin America.
Full Time: Monday – Friday 8am – 5pm
The Financial Advocate performs detailed, in-house reviews, bedside and/or phone interviews to determine if patient is a viable candidate for federal, state, and/or county medical or disability assistance and, if so, assists the patient/guarantor with the application process for any assistance programs. This assistance includes the necessary investigative, field, and administrative work needed to assist the patient in meeting eligibility requirements for Disability, Medicaid, or other applicable county, federal, or state programs if appropriate. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. Financial Advocate adheres to Florida Hospital Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.
Knowledge, Skills, Education, & Experience Required:
- Substantive knowledge of the Medical Assistance application process.
- Understanding of HIPAA privacy rules and adroit ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties.
- Working knowledge of Microsoft programs and familiarity with database programs.
- Ability to operate general office machines such as computers, facsimiles, copiers, scanners.
- Skill in speaking clearly and distinctly using appropriate vocabulary and grammar to obtain the information necessary to execute job responsibilities.
- Skill in reading documents written in standard English text such as administrative policy and procedures manuals.
- Ability to communicate effectively in writing, with accurate typing /data entry at a minimum of 30 wpm.
- Proficiency in performance of basic math functions.
- Ability to follow complex instructions and procedures, with a close attention to detail.
- Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion.
- Ability to be responsive to ever-changing matrix of hospital needs and act accordingly.
- Availability of reliable transportation for scheduled field visits.
- Successful completion of Financial Advocate training course (approx. 40-50 hours) with minimum of 80% proficiency on final exam
- Minimum of two (2) years of college or two (2) years business, social services, health care, or related experience or comparable combination of education, related experience, and/or training.
- Bachelor’s degree in Social Services, Health Science, or related work field AND.
- Minimum of five (5) years working experience with DCF, SSA or AHCA in eligibility enrollment programs. (Preferred)
- Minimum of two (2) years related experience in Oncology or Specialty Pharmacy. (Cost center 4997 only) (Preferred)
Licensure, Certification, or Registration Required:
- Non Applicable
Demonstrates through behavior Florida Hospital’s Core Values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork as outlined in the organization’s Performance Excellence Program
- Protects the financial standing of Florida Hospital by performing methodical and through financial assessments of our uninsured patients and/or under insured patients assisting in applications for federal, state and local programs that pay on behalf of the patient.
- Screens patients and/or patient’s representative to determine potential eligibility for Third Party Resources. Analyze their income, assets, household composition, and physical conditions, while applying government rules and regulations that will assist in presenting a complete case to the respective Government Funded Health Program, i.e. SSA, DCF, SSI, Medicare, Disability, etc.
- Maintains timely and effective communication with patient to insure complete understanding of Health Program’s processes. Meets with patient or the patient’s representatives either in hospital or other location as designated by supervisor to apply for financial assistance programs.
- Explains to patients and other entities the eligibility requirements, application process and verification requirements for applicable programs. Facilitate the application process when appropriate for the patient by assisting the patient in completing the application, scheduling appointment interviews and obtaining required verifications.
- Represents patients that cannot represent themselves at the offices of Immigration Services, Social Security Administration, Vital Statistics, and Attorney offices, due to their illness. Maintain in communication with Adoption Agencies, Foster Care Program, and Adult Care programs for patients whose cases have been forwarded to these organizations and still pending with no decision. Responsible for timely intervention and escalating to the manager for awareness and assistance.
- Maintains, updates and has thorough knowledge of policies and procedures, rules, regulations, and technical objectives as they are used by DCF, SSI, SSA, AHCA, Medicare, Benefit Recovery, Child Support Enforcement, Foster Care, Adult Protection, Bureau of Victim Compensation, and Labor Dept; as they apply to patients that are undocumented, legal alien, disabled, children, adopted, emancipated. Complete knowledge of technical requirements needed for a hearing on denied cases and how to overturn decision. Ensures knowledge is shared with Case Management and other key members in the revenue cycle department.
- Meets minimum conversion goals based upon the opportunity to ensure protection of Florida Hospital’s financial standing. Meet the minimum standard of accounts and dollars by staying involved with application process from start to decision of all applications. Monitor patient accounts to ensure appropriate processing timeframes are met.
- Enters all account notes and status codes on all applications entered on web. Document account activity as required by policies and procedures in order to support account dispositions. Receive approvals from DCF, enter notes. Submit accurate information so accounts can be billed appropriately.
- Responsible for escalating high dollar accounts, aged accounts, and share of cost accounts that exceed a certain period of time to the manager for intervention.
- Adheres to compliance and security regulations including HIPAA by accessing and releasing PHI as minimally necessary to perform duties and according to procedures.
- Responsible for working with external agencies for those who do not cooperate timely. Maintain proper notes for the referral and is responsible to ensure all internal efforts were exhausted prior to the referral to our business partners.
- Responsible for accurately documenting time record for all time worked and maintaining the work schedule as assigned.
- Other duties as assigned.
The above statements reflect the general duties and responsibilities necessary to describe the principal functions of the job, as identified, and shall not be considered an exhaustive list of job responsibilities which may be inherent in the job. Responsibilities are subject to change.
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Financial Advocate opportunity with Florida Hospital and apply online today.
The Skill To Heal. The Spirit To Care.®