Patient Advocate Job Description

Patient Advocate Job Description

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Patient advocate provides basic information about private insurance, Medicare, and Medicaid coverage that can affect your acute and post-hospital care.

Patient Advocate Duties & Responsibilities

To write an effective patient advocate job description, begin by listing detailed duties, responsibilities and expectations. We have included patient advocate job description templates that you can modify and use.

Sample responsibilities for this position include:

Handle incoming calls from customers, and place outgoing calls to patients and healthcare partners to remove insurance barriers
Proactively build trusting relationships with patients and healthcare partners
Is able to understand the PEAK, Connect for Health, HealthCare.gov and KanCare web-based decision tools and guide patients through the process of narrowing choices for qualified health plans
Ensure accuracy of patient information
Perform front desk reception duties
Complete audits as assigned
Obtain and coordinate record retrieval
Process record requests
Fulfill all compliance responsibilities
Arrange transportation for members, as needed

Patient Advocate Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Patient Advocate

List any licenses or certifications required by the position: CPR, MA, BLS, CPI

Education for Patient Advocate

Typically a job would require a certain level of education.

Employers hiring for the patient advocate job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Healthcare, Nursing, Education, Social Work, Psychology, Health, Public Health, Coaching, Health Administration, Patient Care

Skills for Patient Advocate

Desired skills for patient advocate include:

Health care field and medical terminology
Healthcare
Microsoft Office
Medical terminology
Medicaid
Auto Insurance process and requirements
Managed Care
Medicare
Private Insurance
Clinic philosophy and policies and operating procedures

Desired experience for patient advocate includes:

Work collaboratively with other customer service
High school diploma or equivalent and up to 1 year of relevant working experience
OR 4 + yrs
Requires the ability to sit and be stationary for prolonged periods of time, normal or corrected vision and manual dexterity sufficient to perform work on a personal computer
Required or equivalent work experience directly related to patient care administration and/or social work with at least 4 years of experience
Arrange follow-up appointments for member, as needed

Patient Advocate Examples

1

Patient Advocate Job Description

Job Description Example
Our innovative and growing company is looking for a patient advocate. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient advocate
  • Input accurate patient demographics into Centricity
  • Process admin hold and in process orders
  • Identify and provide suggestions to issues as appropriate
  • Assist Lead Insurance Verification Coordinator as required
  • Assists with review of financial responsibility with patient or family member and obtain payment mechanism
  • Ensures that all financial assistance applications are processed timely and accurately
  • Follow up with existing patients to obtain new or renewal copay assistance cards
  • Researches, obtains and coordinates financial assistance for Specialty Pharmacy patients
  • Researching and updating manufacturer copay assistance programs as needed and annually
  • Track and monitor patient's with approved assistance grants and reapply for more funding as needed
Qualifications for patient advocate
  • Clearly, speak, read and write in English is required
  • Three years experience in a professional medical office setting, health plan and patient advocacy/conflict resolution capacity required
  • Demonstrated skill in and understanding of medical office operations, systems, and processes (front office, back office, and health plan requirements)
  • Direct experience in and understanding of customer service role
  • Experience working with physicians, managers and staff to accomplish goals and objectives through influence and persuasion, as opposed to direct lines of authority
  • Ability to work with and effectively communicate (both verbally and written) with a diverse work force in all levels of the organization
2

Patient Advocate Job Description

Job Description Example
Our company is hiring for a patient advocate. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient advocate
  • Documents and tracks complaints and resolutions in a database
  • Rounds on all acute care services and in the emergency department to assure patients/families’ questions and concerns are answered
  • Brings concerns to unit managers or appropriate medical directors, serving as a resource for interventions related to dissatisfied patients/families/physicians and supports an environment of proactive service recovery
  • Follows up with managers and medical directors to monitor/ensure timely grievance resolution, and to ensure completion of all required documentation
  • Maintains contact with complainant throughout the process to facilitate timely and effective grievance resolution and service recovery
  • Resolve patient issues by researching the patient’s account and correcting insurance information, demographics
  • Complete all aspects of statement processing for assigned outsourcing clients in a timely, accurate, and high-quality manner
  • Complete all aspects of collection processing for assigned outsourcing clients in a timely, accurate, and high-quality manner
  • Work with the state Operations staff with regard to responding to complainants and collection of information as necessary
  • Assist in preventing complaints on the front end by collaborating with supervisors and managers who identify developing problems offer suggestions to resolve potential complaints and modify practices that cause repeated complaints
Qualifications for patient advocate
  • Strong conflict resolution, facilitation and follow-through skills
  • Must have valid driver's license, a working registered vehicle and proof of vehicle insurance
  • Understanding of medical and insurance terminology preferred
  • Proficiency in the use of Microsoft Access preferred
  • Accurate touch-typing with a minimum speed of 30wpm
  • A minimum of three (3) years’ work experience in a medical setting required
3

Patient Advocate Job Description

Job Description Example
Our company is growing rapidly and is looking for a patient advocate. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient advocate
  • Educate patients about Connect for Health Colorado (C4HCO) and Health Care.gov by meeting with patients in person or via phone to explain services available, reasons to buy health insurance, and options for coverage
  • Educate and assist patients on affordable payment plan options while adhering to the SCL payment plan guidelines
  • Resource for Financial Health Advocates, Leads and Charity Reps, providing follow-up or research into patients pending eligibility
  • Full understanding of requirements of the states CICP program, processing qualifying account adjustments within acceptable timeframe
  • Follow up with the state on cases pending eligibility and/or contacting patient or site FHA for additional information on pending accounts requiring more than originally provided
  • Responsible for maintaining and reporting out on Indigent Care work queues
  • Ability to add and term coverage properly, ensuring that billing is initiated when appropriate
  • Primary contact for MA (Medical Assistance) Site following up submitted cases awaiting determination
  • Informs self-pay patients of liability due, prepayment requirements and coordinates screening of alternate funding sources if applicable
  • Assist management with Quality Review
Qualifications for patient advocate
  • Proficient in Centricity
  • Knowledge of Specialty pharmacy payers, medications and insurance verification highly desired
  • Knowledge of financial assistance programs desired
  • Experience in managing patient complaints and interpreting hospital policies and procedures to patients
  • Team oriented and have demonstrated strength in working with staff at all levels
  • Bilingual also a plus
4

Patient Advocate Job Description

Job Description Example
Our innovative and growing company is looking for a patient advocate. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient advocate
  • Assists with new hire and remedial training
  • Daily monitoring of system site work queues, reporting out monthly KPIs to leadership
  • Establishes acceptable payment arrangements on self-pay accounts
  • Responsible for presumptive eligibility population by actively reaching out to patients, verifying quick qualification
  • Collects patient payments and provides receipt accurately completing all required fields
  • Complete, pass, and maintain Colorado’s state certification for CAAS (Certified Application Assistance Site) Colorado’s Outstationing grant program
  • Documents patient account notes for all interactions/transactions in EPIC and/or CAC Tracker
  • 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
  • Knowledge and understanding of the 501r Regulation – do we need?
Qualifications for patient advocate
  • Participates in development of assistance processes adopted by the department to support OCM
  • For presentation to the patient, creates financial snapshots through the use of historical claims data, calculation tools and other effective methods outlining cost of treatment
  • Counsels patients regarding availability of support as needs are identified through evaluation of potential costs or other interactions with patients
  • Makes referrals to services or individuals internal/external to the organization for further supportive actions, for example distress counseling, patient services such as transportation
  • Reviews claim issues, with special emphasis on the OCM project billing and data reporting
  • Reviews patient insurance plans for coverage and identifies areas for improvement to support the patient’s overall financial health
5

Patient Advocate Job Description

Job Description Example
Our company is growing rapidly and is hiring for a patient advocate. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient advocate
  • Proactively build trusting relationships with patients, providers, or other stakeholders ensuring their best interests are met
  • Act as a patient advocate ensuring all existing barriers impeding a needed therapy are identified and necessary steps are taken to remove them
  • Manage and respond to incoming calls and determine how best to meet the needs of the customer
  • Provide oversight and guidance on the transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate
  • Assist with the training of new Patient Access Advocates
  • This position services calls in a warm and empathic manner as many of the calls are sensitive in nature
  • Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and training to effectively address callers needs in an educational manner
  • Facilitates resolution of complaints/grievances/requests by patients and visitors in accordance to legal and regulatory requirements
  • Maintains tracking system in accordance to organizational policy and regulatory requirements
  • Collaborates with unit and facility leadership to meet customer service and clinical quality outcomes for the customer service
Qualifications for patient advocate
  • Assist in tracking oral chemotherapies, and any other OCM related requirement, as appropriate
  • Communicates with internal staff and MDs as necessary based on individual patient concerns
  • Is prepared to develop additional competencies related to the OCM project and internal department needs as position develops
  • Bachelor’s Degree, preferably in a financial, social work, counseling or related field
  • MSW in Social Work preferred
  • Must have experience in Medical Oncology/Hematology or other specialty dealing with terminal care, preferably in counseling, revenue cycle management and/or pharmaceutical support program management

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