Financial Family Advocate II (Finance)

Nemours is seeking a Financial Family Advocate II (Full-Time), to join our team in Orlando, Florida.

Utilizing high-level customer service, healthcare finance knowledge, and excellent communication skills, the Family Financial Advocate II will facilitate, educate, and communicate to patients/families about the financial aspects of seeking treatment at Nemours. The Family Financial Advocate II may be able to cross cover other teams and areas within PFS department. Serve as a resource to other PFS and clinical teams. Support with patient/families and provider escalation and provide resolution. Work involves conducting interviews, gathering, assembling, and reviewing sensitive information supplied by applicants, relevant to the initial and on-going Nemours Financial Assistance Policies and Medicaid Programs. The Family Financial Advocate II will work directly with insurance carriers or with internal insurance verification personnel to determine benefit level, coordination of benefits, coinsurance and deductible amounts and communicate financial obligations to the guarantor. This role will be responsible for determining a suitable financial assistance program for each family identified as being in need, developing payment arrangements, collecting prepayments (pre-service deposits and out of pocket costs), providing cost estimates to patients and providers, and approving discounts in accordance with organizational and government policies. In addition to providing financial assistance and resources, the Family Financial Advocate II will research and address a broad range of inquiries covering items such as insurance regulation and processing protocols, charge discrepancies, benefit interpretation and adjudication. This role is also responsible for supporting the Medicaid Enrollment processes.

• Protects the financial standing of Nemours by performing methodical and thorough financial assessments of our uninsured and/or underinsured patients assisting in applications for federal, state, and local programs. Conduct Pre-Service Financial Screening and Financial Clearance Interviews.
• Ensure compliance with hospital financial resolution policies, including conducting financial interviews with patients and families to assist with resolution of their account. Initiates and completes charity applications on accounts at risk. This includes Nemours Financial Assistance Programs and Uninsured discount Programs.
• Ensure productivity of various Workqueues to identify, verify, and assuring all accounts are ready for billing with adequate supporting documentation, within the established time frames.
• Serves as a support to patients and their family members to assure patients have access to all available funding options, this involves working with private as well as governmental agencies, i.e., private insurance, HMO/PPO's, Medicaid, Medicare, and Third-Party Liability payers.
• Convey courtesy, dignity, respect and a positive attitude through words and actions to establish harmonious relationships with all individuals. Demonstrate effective communication and respect by using active listening skills, positive body language and effective verbal, written and electronic forms of communication. Demonstrate care and concern and inclusion when interacting with and informing customers by consistently using A.I.D.E.T and protecting confidentiality and privacy.
• Aid in customer service resolution with concerns regarding financial services. Including but not limited to giving advice and counsel to patients and guarantors of their rights, responsibilities, and procedures about payment for care.
• Analyzes insurance benefits or determines self-pay arrangements to create estimates for patient responsibility in the determined timeframes. Educates patients/families of their insurance coverage, non-covered services, and any expected patient responsibility. Coordinate international patient's appointments and financial arrangements.
• Handles inbound and outbound calls including but not limited to pre and post service collections, customer service calls and account inquiries.
• Responsible for the quality integrity related work revolving around Accounts Receivable & Self Pay Process.
• May support with scheduling functions, other projects, and duties as assigned by supervisor.
• Other duties as assigned.

Job Requirements

• Associate Degree (2 years of training beyond high school, e.g., Associate's degree) required.
• Minimum three (3) years of experience required.
• Working knowledge of patient accounting functions including pre-admissions and admission registration will be considered in lieu of an Associate Degree.
• Minimum one (1) year Financial Advocate experience, in addition to registration, insurance, billing, and/or relevant experience required.
• Knowledge of Epic and EMR applications.