PATIENT FINANCIAL ADVOCATE

General Purpose

Under the general supervision of the Director Patient Access the Patient Financial Advocate will define and implement best practices to support patients experiencing unexpected financial obligations and/or loss of insurance coverage.  The Patient Financial Advocate will use fact-finding combined with data analysis, case reviews, auditing, gap analysis, and published industry best practices to streamline work, and close identified gaps.   Effectively communicate solutions, issues, and risks directly with management or other responsible entities to ensure a fully integrated solution across multiple work streams.

Essential Duties

• Perform patient financial advocacy, business analysis, process evaluation, design and documentation duties primarily related to creating the ideal patient financial experience. 
• Serves as a patient advocate by resolving complicated escalated billing, financial counseling, and authorization related issues and integrate solutions into best practices, using outstanding and proven customer service skills with the ability to successfully de-escalate sensitive patient calls.
• Is personally responsible for patients and families who require ongoing complex financial care for the duration of those patients’ medical care at Michigan Medicine and the processes that impact the patients.
• Monitors and proactively manage the financial status of patients with very complex financial constructs, communicating with internal and external customers, i.e. the patients, families, attorneys, assistance programs, insurance companies needed to make sure that they have the best financial experience possible.
• Works closely with leaders and organizations to help serve Sparrow communities, including the UMH Sparrow rural health clinics and programs.
• Participate in all UMH Sparrow sponsored community events.
• Works directly with the communities and other organizations to decrease Ingham, Eaton, Clinton, Montcalm, Gratiot, Ionia, and Shiawassee counties uninsured rates by educating patients on the importance of health insurance, various plans and networks along with increasing Marketplace and Medicaid insurance enrollment.
• Community outreach includes participating in community and other organized events, presenting to target audiences, and connecting with underserved populations within the community (example: community fair, presentation to civic groups, health fairs etc.)
• Serve on standing community organizations and outreach programs to form mutually beneficial partnerships (example: Lansing – Cristo Rey Community Health Center & Care Free Clinic, and like organizations within our broad service area)
• Enroll patients in ACA and Medicaid plans and work closely with DHHS workers on pending applications.
• Provide necessary education and training to staff on tools and resources to support the financial success of the Pre-Service division.
• Partner with vendors, payers, internal customers, and peer organizations to achieve optimum performance of technology and processes.
• Participate in KPI and Metrics reporting collection, presentation, and other community connection documentation needed for non-profit, government regulatory, or other community outreach reporting.
• Analyze business and user needs, documenting requirements and revising existing system or process difficulties.
• Analyze, compare and evaluate various courses of action.
• Competence in applicable phases of systems analysis and considers the business implications of the application of technology to the current business environment.
• Perform other related duties as assigned. Opportunities may exist to work on other departmental projects based on current workload and needs.

Job Requirements