Note: The job is a remote job and is open to candidates in USA. Gillette Children's is a healthcare organization seeking a Financial Advocate to support patients, families, and care teams with financial coverage and billing needs. The role assesses patient financial profiles, verifies insurance eligibility, provides estimates and financial counseling, coordinates resources, and supports accurate prior authorization and revenue cycle processes.
Responsibilities
- Information – Finds, effectively uses and provides information when requested. Readily adjusts to shifting priorities and work assignments
- Collaborates with Social Work team to connect patient with resources and provide content expertise regarding coverage for services
- Assist and educate patients and/or families with a host of services to ensure the process of collecting payments is fully explained and is as comfortable as possible. Explains Gillette’s billing model to ensure understanding of billing and expenses
- Assess patient financial profile, determining whether the patient is eligible for charity care or other programs
- Utilize all available resources (technology/people) to optimize the patient experience
- Apply knowledge of insurance plans to verify insurance coverage and eligibility and payer requirements
- Obtains/updates and documents patient demographic, financial and medical information, with a high level of accuracy for the provision of services, and is accountable to provide quality, complete and timely prior authorization of patient services to maximize financial return to Gillette Children’s Specialty Healthcare
- Serves as an escalation resource for other team members regarding revenue cycle related concerns
- Accurate and Efficient Work – Demonstrates accuracy, efficiency and completeness in products and processes. Performs tasks with appropriate urgency and accuracy while reducing waste through proactive time management
- Completes all required components to ensure coverage of Gillette services including financial counseling and estimate development
- Demonstrates effective and timely management of assigned work queues and areas of responsibilities
- Consistently follows all current department and organizational guidelines and workflows
- Takes initiative and is proactive in use of time and project completion
- Identifies opportunities for improved workflow
- Maintains the highest standard of patient confidentiality
- Maintains a calm, warm and professional demeanor while interacting with others (telephone and in person). Uses de-escalation techniques in stressful situations
- Competence in Technology Required of the Position – Demonstrates understanding of the tools and systems needed to accomplish work
- Demonstrates competency in organizational systems including: electronic medical record, office equipment, online resources, and other relevant technology to perform all necessary job functions
- Proactive use of technology. Leverages automation and tools to improve efficiency and quality of work
- Procedure and Policies – Follows established procedures and policies. Protects the confidentiality of personal health information
- Adheres to all organization and department policies, guidelines, workflow to eliminate errors in practice
- Adheres to organization and department attendance policy
- Active Engagement – Be actively involved
- Is on time for work and ready at start of shift
- Attends and is engaged in team meetings
- Demonstrates a positive approach to work
- Initiates goal development, consults with leader, and enters into HR system
- Completes self-assessment timely and with contributing comments
- Completes all mandatory annual requirements within established timeframe
Skills
- High School Diploma/GED
- 3 years' experience in customer service with at least one year in a healthcare setting
- Experience working with commercial and government insurance carriers and insurance forms
- Intermediate understanding of hospital billing requirements and understanding of Explanation of Benefits (EOB), Contract Language, and Commercial and Government Payer Requirements
- Understanding of HCPCS/CPT Coding
- Knowledge and understanding of medical terminology
- Ability to problem-solve and address customer service concerns independently
- Desire to work directly with patients/families, exceptional telephone etiquette
- Ability to build relationships with patients, providers, insurance payers, and peers
- Conflict resolution and de-escalation skills
- The selected candidate must reside in Minnesota or Wisconsin and have the ability to work onsite in St. Paul, MN as needed
- Experience with Medical Audits and Appeal submission
- Experience with hospital-specific computer systems
Benefits
- This position will require initial on-site training, and then will transition to a remote working role.
- Gillette supports career progression
- Retirement savings match
- Tuition and certification reimbursement
- Paid time off
- Health and wellness benefits for .5 FTE and above
Company Overview