Full Time
Pearland, TX, USA
Posted 3 months ago

Patient Advocate

Altus Infusion- Patient Advocate Position

Essential Duties:

  • Verify in network and out of network insurance benefits on patients for assigned client(s).
  • Communicate with patients about financial responsibility and appointments, including amounts due at time of service and any account balances.
  • Refer patients to appropriate financial assistance programs via assistance benefit investigations through internal assistance program specialists.
  • Manage all of the communication between the doctor’s office, the patient, and our corporate office.
  • Obtain authorizations, referrals, pre-determinations and pre-certifications as required by the patient’s plan.

 

Expectations:

  • Have all patient’s insurance benefit investigations, authorizations, and determined cost share completed one week prior to patient’s scheduled infusion. This includes coordinating with various departments to determine if patient’s in or out of network benefits will be utilized and what types of financial assistance is available to the patient based on their plan type and diagnosis.
  • Communicate patient cost share responsibilities with patient one week prior to patient arrival for infusion. This may require multiple calls to patient, leaving HIPAA compliant voice mails and waiting for patient to return call in order to accomplish this task. This may also require asking clinic staff to assist in contacting patient after multiple attempts to reach patient have failed.
  • Have all necessary authorizations on file with payer prior to patient’s scheduled infusion. Failure to do so may result in denied claims, which results in loss to Altus Infusion, and may result in disciplinary action, up to and including termination.
  • Complete a “New Start” patient within 3 business days from the date new order received. This includes making initial contact to introduce oneself to new patient, verifying insurance and financial assistance benefits, obtaining authorization, notifying patient of financial responsibility and ready to schedule status, and notifying clinic of patient’s readiness to schedule. This step also requires coordination with multiple departments to determine if patient’s in or out of network benefits will be utilized and what type of financial assistance is available to the patient based on their plan type and diagnosis.

 

  • Ensure accuracy of all Verification of Benefit (VOB) forms, accuracy of all quotes of benefits communicated to patient, accuracy of amounts to be collected at time of service communicated to clinic via daily collection sheet, accuracy of patient status as in or out of network marked on VOB and daily collection sheet.

 

Additional Duties and Expectations:

  • Follow all corporate, local, state and federal guidelines, including HIPAA and protecting patient confidentiality.
  • Treat each patient as if they were a family member and take ownership of responsibilities.
  • Some travel may be required.
  • Ability to read and interpret written and verbal communication such as procedure manuals, insurance verification forms, insurance verification calls, insurance pre-determination and authorization forms. Ability to write correspondence and complete forms.
  • Ability to speak effectively to patients and coworkers.
  • Ability to communicate in a high pressure environment. Forms of communication may include verbal, written, and non-verbal, via the use of facsimile, email, phone and person to person.
  • Ability to apply concepts of basic mathematics.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to manage multiple patients for multiple accounts.
  • Possess good interpersonal skills.
  • Adaptability/open mind to changes.
  • Ability to audit third party work.
  • Additional duties as assigned by management.

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