Summary:
Under general supervision and working exclusively within the premises of the hospital to serve as a liaison between the hospital patients and family members to ascertain develop and secure resources which may be available to patient and family members for the resolution of medical expenses incurred. Pre-admit all Self-Pay In and Outpatients and arrange payment terms for services as circumstances warrant.

Responsibilities:
Identify and assist patients and family members who do not have medical coverage and who appear not to have the financial means to make payment nor have the experience and knowledge regarding available resources that may meet their medical expenses if it can be established they qualify for these resources.



Obtain referrals from registration personnel who check in patients on those patients who may qualify for assistance.



If the patient/family does not qualify for available resources the Advocate within the limits of hospital policy and procedure will assist patients/family members with the processing of Community Free Service applications.



Self Pay ED Direct Admissions that are Inpatient/Observation patients are the responsibility of the Patient Advocates who will verify demographics prepare and assemble necessary paperwork as well as establish financial arrangements with the patients.



Scheduled Self Pay Outpatients and Inpatients will be pre-admitted/pre-registered by the Advocates.



Develop and maintain databases concerning available medical financial resources and benefits that may serve our patients.



Establish contacts and relationships within the health care and human resources community that will benefit patients family members and the hospital.



Follow current trends within the health care and human service fields that may impact on patients family members and the hospital either positively or negatively.



Establish intra-department contacts to foster cooperative relationships that are of mutual benefit. Specific emphasis to be placed on the development of communication with Social Services Clinical Managers the Medical Staff and Patient Financial Services.



Research Patient Accounts written off to the General Public Assistance adjustment account for possible discovery of alternative (Medical Assistance) coverage.



Reactivate account records and account balances that have been written off to General Public Assistance or Community Free Service when alternative coverage (Medical Assistance) is discovered.



Report any discovered Third Party Payer coverage to hospital collection/recovery agencies when applicable.



Notify CPRO (Connecticut Peer Review Organization) regarding appropriate Inpatient Medicaid cases when coverage is discovered.



Prepare and maintain monthly productivity reports and financial statistics as management requires.



Prior to service contact all uninsured patients to verify demographics and establish payment arrangements.



Review payment requirements with referred insured patients who cannot meet their financial obligations including previously incurred hospital balances current admission/outpatient expected non-covered charges and ABN*s and make arrangements for collection of same.



Review/interview patient referrals prior to or at discharge as policy requires to be sure they are cleared financially at discharge/release. Establish payment arrangements as circumstances warrant.



Contact referring physician to determine urgency of services when the patient refuses or is unable to pay. Arrange to re-schedule such services if they are non-emergent/non-urgent patients.



Prior to service review existing account histories with self pay or insured patients and family members to negotiate and establish payment terms to close any existing open balances greater than $500 or any balances unpaid for 30 days or more.



Discuss payment plans with all self-pay direct and ED admissions.



Use Credit Reporting to assist in the development of payment plans.

Other information:
BASIC KNOWLEDGE:

A level of knowledge generally obtained through High School.



Good verbal and written communication skills.



Computer skills.



Ability to communicate with patients and family members with empathy while at the same time retain a professional relationship.



Have knowledge of forms documents income/asset regulatory parameters involved with the establishment of eligibility for financial resources and benefits available to qualifying patients and family members.



Know and understand United States Immigration Laws; including the rights benefits and limitations affecting individuals through their alien status.



Have knowledge and familiarity with credit resources finance plans terminology documents and hospital policy regarding their utilization.



Have knowledge and skills concerning use a Personal Computer including use of hospital systems preparation of reports and correspondence as well as to be able to use and access

e-mail and the internet.



Have knowledge of medical terms and conditions that may support the establishment of patient eligibility for medical benefits.



Have knowledge of regulations concerning patient personal confidentiality (HIPAA).



EXPERIENCE:

Two years in a hospital environment with involvement in experience with third party payer coverage.



Computer skills required.



WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Working conditions are generally good; there is some exposure to the normal patient care environment as some patient interviews are conducted with patients at the Nursing Units.



SUPERVISORY RESPONSIBILITY: None

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.

Location: Rhode Island Hospital USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union