Job Description

Patient Financial Advocate

A Brief Overview As a Financial Counselor, you'll help patients navigate one of the most complicated parts of their healthcare experience: understanding and managing the cost of care. You'll serve as a trusted financial advocate, helping patients understand insurance coverage, expected costs, financial assistance, Medicaid eligibility, payment options, and other resources that may make care more accessible. You'll work directly with patients and families to answer questions, identify solutions, and reduce financial barriers before and after services are provided. You'll also partner with providers, community agencies, and internal teams to support financial clearance, accurate estimates, reimbursement, and a positive patient experience while maintaining organizational and regulatory requirements.

What You Will Do Provide compassionate, timely financial counseling and support to patients before scheduled services. Prepare and explain patient estimates and Good Faith Estimates (GFEs). Help patients understand deductibles, copayments, coinsurance, out-of-pocket costs, and other financial responsibilities. Review insurance benefits and explain coverage limitations that may affect a patient's costs. Guide patients through out-of-network benefits, reference-based plans, self-pay options, and other financial considerations. Conduct financial counseling appointments for IVF and other specialty services. Help patients establish payment arrangements, explore financing options, and make initial payments when appropriate. Conduct pre-service financial clearance and collection activities. Proactively reach out to patients who may need additional financial support before receiving care. Identify financial or reimbursement concerns early and connect patients with appropriate solutions or additional review. Connect patients with financial assistance and coverage Help patients understand and apply for available hospital financial assistance programs. Guide patients through application and documentation requirements. Assess financial hardship and identify programs and resources that may help. Assist patients with Medicaid applications, renewals, redeterminations, and eligibility verification. Support presumptive eligibility screenings and enrollment. Follow pending Medicaid applications through eligibility determination. Serve as an Authorized Representative for patients when properly designated. Partner with county agencies, managed care organizations, government agencies, and community resources to help patients access coverage. Educate uninsured and underinsured patients about Medicaid, insurance, financial assistance, and other available resources. Be a trusted resource when patients have financial questions Listen to patient concerns, research account questions, and provide clear solutions and next steps. Manage inbound and outbound financial counseling calls. Answer questions about estimates, Good Faith Estimates, insurance coverage, Medicaid, payment plans, financial assistance, billing concerns, and financial clearance. Provide proactive support to patients who may be financially at risk. Connect patients with Customer Service or other departments when additional assistance is needed while helping ensure a smooth handoff. Escalate sensitive or complex concerns to the appropriate team. Create a positive patient experience through education, communication, empathy, and financial advocacy. Help improve access to care and the patient experience Participate in community outreach events, health fairs, enrollment programs, and educational activities. Support efforts designed to expand healthcare access and connect uninsured patients with available resources. Review reports, worklists, and account information to identify opportunities to improve processes and the patient experience. Contribute ideas for improving workflows, technology, financial counseling practices, and patient engagement. Support department projects, reporting, analytics, and performance initiatives. Participate in initiatives involving financial counseling, Revenue Cycle performance, patient engagement, enrollment, and health equity. Assist with training, mentoring, and onboarding as assigned. Stay current on industry practices and share opportunities for improvement with leadership. Additional Responsibilities You'll help ensure financial counseling activities follow applicable requirements, including the No Surprises Act, Good Faith Estimate requirements, financial assistance requirements, CMS guidance, Medicaid requirements, and organizational policies. You'll protect patient privacy and securely handle Protected Health Information (PHI) in accordance with required training, the UH Code of Conduct, and organizational policies and procedures. You may also perform additional responsibilities based on department needs, with more detailed processes and expectations provided during orientation.

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