Note: The job is a remote job and is open to candidates in USA. Transformations Care Network is dedicated to improving accessibility in behavioral health. The Patient Financial Advocate serves as the primary contact for patients regarding billing and payment options, ensuring a positive financial experience while supporting the organization's revenue cycle performance.
Responsibilities
- Answer inbound calls from patients regarding billing statements and account balances
- Explain charges, insurance payments, deductibles, coinsurance, and patient responsibility in a clear and professional manner
- Review patient accounts within NextGen PMS to ensure accurate balance interpretation
- Identify and resolve discrepancies or escalate appropriately when needed
- Set up standard payment plans according to established policies
- Process secure payments and provide receipts or confirmation as required
- Document all patient interactions thoroughly and accurately within the system
- Provide empathetic, non-judgmental support during financial conversations
- Educate patients on insurance processing timelines and benefits explanations
- Communicate financial policies clearly and consistently
- Screen patients for financial assistance eligibility when applicable
- Maintain accurate account notes following standardized documentation guidelines
- Ensure compliance with HIPAA and organizational privacy policies
- Follow established call handling and quality assurance standards
- Protect PCI compliance standards when processing payments
- Meet established service level and quality benchmarks
- Support key metrics including: First-call resolution, Payment plan adherence, Dollars collected per representative, Documentation accuracy
- Maintain knowledge of mental health billing, department policies and procedures
- Develop and maintain positive working relationships with cross-functional teams, teammates and Payor representatives and other key stakeholders
- Consistently meet or exceed the department productivity and quality standards and performance requirements
- Collaborate as needed to identify and resolve underpayments and overpayments
- Other duties and responsibilities as assigned including but not limited to: Work overtime with little or no notice as needed, Attend team meetings, phone conferences, and training as needed
Skills
- High school diploma
- Minimum 2 years of physician billing or revenue cycle experience
- Experience reviewing patient accounts and explaining insurance benefits
- Strong verbal communication skills with a patient-centered approach
- Basic knowledge of insurance terminology (EOBs, deductibles, coinsurance, etc.)
- Proficiency in medical practice management systems (NextGen experience preferred)
- Ability to navigate multiple systems while actively speaking with patients
- Self-starter; able to move own workflow along with minimal oversight
- Accurate; detail oriented and able to meet tight turnaround times
- Strong written, verbal, and interpersonal communication skills
- Ability to exercise initiative, judgment and decision-making skills
- Intermediate computer skills and proficiency in MS word, excel outlook and database management and internet usage
- 4+ years of physician billing and accounts receivable in healthcare
- Prior call center or high-volume inbound call experience
- Knowledge of payment plan structures and financial assistance policies
- Familiarity with revenue cycle workflows from charge entry through payment posting
- Certified Revenue Cycle Representative or other billing certification
Benefits
- Medical
- Dental
- Vision
- Low-cost virtual care
- Dependent and domestic partner coverage
- 401K
Company Overview