Patient Advocate

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

The Patient Advocate contributes to quality patient care by providing a communication link between patients, families, and the hospital and clinics. Responsibilities include routine rounding on patients/families, addressing patient/family complaints in real time, investigating and handling difficult situations and facilitating for positive responses and grievance resolution; tracking complaint information; tracking and following up on patient claims to the State Department of Accounting and General Services (DAGS); providing statistical data; analyze patient experience data and participate in patient experience improvement efforts, and other duties as assigned.

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

This is a REMOTE position within US only.

Knowledge and Abilities Required: Knowledge of: Principles and practices of customer service, public relations and investigations; Health Care organizations; report writing; computer skills; medical terminology; Health Insurance Portability Accountability Act (HIPAA) regulations; hospital policies and procedures; State/Federal Public Health Laws.

Ability to: Establish and maintain effective working relationships with personnel possessing a wide range of educational and work experience backgrounds; understand and apply laws, agency regulations, and other pertinent guidelines and requirements; analyze facts and statistical data; speak effectively before groups; prepare statistics and written reports; make sound observations and recommendations; deal tactfully and effectively with people; prepare clear and concise reports; and supervise the work of others.

Examples of Duties: (The following are examples of duties and are not necessarily descriptive of any one position in this class. The omission of specific duties statements does not preclude management from assigning such duties if such duties are a logical assignment for the position).

• Help patients navigate the healthcare system to reduce service fragmentation and ensure timely access to care and providers;
• Establish close relationship with and serves as the primary point of contact for patients;
• Review and processes all incoming and outgoing referrals;
• Enter and verify patient demographic and insurance information and secures necessary authorizations;
• Assign referrals to the appropriate provider and patient as needed;
• Update referral status and document outcomes, ensure closure of the referral loop;
• Monitor pending referrals to ensure timely scheduling and follow-up;
• Assist in coordinating patient referrals to specialty providers;
• Facilitate communication between patients, caregivers, referring providers, and insurance companies;
• Ensure accurate data entry, prompt communication, and consistent documentation;
• Work closely with the healthcare team, which may include physicians, nurses, and other clinical staff to support positive patient outcomes; · Perform various administrative tasks such as answering phones, compiling data, preparing reports and correspondence, copying and filing documents, procuring supplies, and attending meetings; · Adhere to all relevant laws and regulations regarding confidentiality;
• Perform other related duties as required.

Education Requirement:  Bachelor's degree from an accredited four (4) year college or university in Healthcare Administration, Psychology, Sociology, Communications, Public Relations, Nursing, Social Work, or related field.  

Experience Requirement: Two (2) years of progressively responsible professional work experience in a healthcare setting with administrative, analytical, customer service, community organization, or patient relations programs. Demonstrated ability to identify, collect, and analyze data; recommend solutions for a course of action in accordance with rules, regulations, and/or other guidelines; communicate effectively, orally and in writing; and plan, organize, and carry out assigned activities independently.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.