The Financial Health Advocate is responsible for providing financial advocacy counseling and enrollment services to individuals who are uninsured and underinsured.
The PFA determines patient’s financial needs by assisting patients in applying for Medicaid coverage, qualifying for State or Federal programs, education of the Affordable Care Act, presenting patients with payment plan options, and identifying individuals who are in need of Financial Assistance.
This position is responsible for quality assurance in application processing and procedures, along with adhering to all compliance requirements mandated by CMS, HIPAA, JCAHO, etc.
Acts as liaison between departments located at the care site and/or RSC; fostering open communication and team work, utilizing positive and effective communication with all team members.
- Ability to screen patients and determine potential eligibility for State Medicaid (MAGI, LTC, and Federal Disability programs (SSI/SSDI) and assist with the application process.
- Deliver education in regards to explaining affordability programs, qualified health plans, essential health benefits and rights when using insurance.
- Educate patients about Connect for Health Colorado (C4HCO) meeting with patients in person or via phone to explain services available, reasons to buy health insurance, and options for coverage
- Is able to understand the PEAK and Connect for Health web-based decision tools and guide patients through the process of narrowing choices for qualified health plans
- Educate and assist patients on affordable payment plan options while adhering to the SCL payment plan guidelines
- Establishes acceptable payment arrangements on self-pay accounts.
- Understanding of SCL’s Financial Assistance Policy and procedures.
- Ability to run and provide estimates to patients for services provided by SCL Health
- Collects patient payments and provides receipt accurately completing all required fields
- Remaining current with the Connect for Health Colorado programs and maintain certification
- Complete, pass, and maintain Colorado’s state certification for CAC (Certified Application Counselor) and CAAS (Certified Application Assistance Site) Colorado’s Outstationing grant program; adhering to the rules and regulations set forth by the State of Colorado.
- Maintains departmental and/or individual work queues and reports as required
- Explains/answers patient billing inquiries and interprets statement data to resolve accounts
- Demonstrates discretion in verbal and written communication with patients and SCL Health staff ensuring patient confidentiality at all times
- Documents patient account notes for all interactions/transactions in EPIC and/or CAC Tracker
- Basic computer knowledge including experience with Microsoft Office Suite.
- High school diploma / GED or equivalent
- One year Financial Counseling experience and/or insurance knowledge
- Financial Counseling experience - 2+ years
- Medicaid / Medicare background
- SSI/SSDI background
- Experience working with Disability based programs strongly preferred.
- Medical record/terminology experience and disability criteria familiarity
- Insurance knowledge
- Previous Certified Application Counselor training (CAC) - State and/or Federal
- Understanding of State and Federal Programs available to the indigent care population i.e. food stamps, Medicaid expansion, SSI, SSDI, etc.
- Previous hospital/medical office, medical insurance and/or customer service experience preferred
- Knowledge and understanding of the 501r Regulation