Patient Benefit Advisor
Company: Beaumont Hospital, Royal Oak (Mich.)
Posted on: May 16, 2023
GENERAL SUMMARY: Under general direction of the Patient Access
Manager - Benefits Advisor, this position is responsible for
assisting uninsured and underinsured patients and their families in
researching and securing potential funding for services provided;
including but not limited to Medicaid, Medicare SSI, and any other
federal, state, Beaumont based, grants, and local programs,
marketplace, auto, and other 3 rd party liability payers. Performs
duties at acute hospital sites, and ambulatory sites. Utilizes
knowledge of billing and payer rules to facilitate determination of
potential resources and seamless processing of paperwork. Works
with Beaumont staff and other providers to recommend referral of
patients to appropriate sites for care.
- Manages the process to ensure that all Benefit Advisors are
educated and trained in identifying patients who are uninsured and
underinsured. Offers alternatives and assists with application
process for Medicaid, Health Michigan, Financial Assistance and
Market Place exchange plans. Works with third party vendors on
complex cases as directed by department policy.
- Advises patients and/or family members of their financial
obligation via all modes of communication, including face-to-face
communication while in the facility.
- Obtains payment in full or secures adequate payment
arrangements/eligibility and benefit information for both inpatient
and outpatient services. Advises patients on expenses associated
with admission. Secures payments or payment arrangements on
self-pay accounts. Discusses third party coverage with patient and
arranges disposition of out of pocket balances due. Informs
patients of payment requirements as soon as possible for inpatient
preferably prior to discharge.
- Advises patients as to their financial liability and assists
with insurance issues and activation of coverage.
- Administers collection program on international and cosmetic
patients as directed per hospital policy to collect
- Utilizes Charge Master, EPIC price estimator, and business
tools to provide cost estimates for complex procedures, surgeries,
and ancillary testing and ensures information is received from
patients and physicians.
- Provides superior customer service to the patient and family by
assisting with completion of required paperwork and program
applications, such as for Medicaid and the Beaumont Charity and
Financial Assistance Programs.
- Serves as a resource to Patient Accounting staff, Social
Workers, and other staff for identification of funding sources for
health services for patients.
- Explains and assists with all discount programs as they relate
to the patient's financial responsibility.
- Communicates with other institutions relative to any prior
- Attends hearings at the state and local level, as needed.
- Assists with the discharge process to extended care facilities
as it relates to the patient's financial responsibility.
- Identifies hospital, public, and / or private financial
assistance programs for patients unable to meet their financial
obligations. Collaborates with Social Services, clinical staff, and
/ or outsourcing company to assist patients / families in
completing assistance program applications and determining
eligibility and coverage. Inputs data into electronic database(s)
and completes daily reports timely and accurately.
- Documents all activities with patients, families, insurers,
D.H.S. workers and providers regarding financial assistance
- Continually works with management in Business Operation Support
to improve the efficiency of data collection as well as ALL
- Provides departments with ongoing feedback to ensure compliance
with third party payer regulations.
- Interacts with other third-party vendors, and Case Management,
Detroit Wayne County Health Authority, and D.H.S. workers to assure
a timely, efficient and accurate financial case.
- Attends department staff meetings and in-services to maintain
current knowledge. Keeps up to date with all department standards
to assure compliance with state and federal regulations.
Responsible for training new employees and instructing current
employees of process changes.
- Special projects as assigned.
- High school diploma or equivalent.
- Associate degree or four (4) years of equivalent experience in
business or related field.
- 2-3 years' experience working with government entitlement
programs (e.g., Medicaid) in a previous financial counseling or
third-party billing role preferred.
- Previous Medicaid application processing experience highly
- Six to ten years of patient accounting, medical billing, or
non-clinical healthcare experience preferred. Knowledge of ICD-9
- Experience working with the public is required.
- Previous Medicaid application processing experience is highly
Other Qualifications :
- Demonstrated self-starter. In-depth knowledge of Medicare &
Medicaid regulations and other insurance plans.
- Excellent oral, written and interpersonal communication skills;
medical terminology, and excellent organizational skills.
- Ability to quickly assess and respond appropriately to
- Ability to comprehend medical terms.
- Analytical skills to resolve complex problems requiring the use
of scientific, mathematical or technical principles, and in depth
experienced based cross-functional knowledge.
- Knowledge and experience with a variety information systems and
Internet usage; experience with spreadsheet and word processing
- Ability to work independently and manage individual workload to
meet productivity standards along with a varied schedule, which
includes weekend and evening coverage.
Keywords: Beaumont Hospital, Royal Oak (Mich.), Taylor , Patient Benefit Advisor, Other , Taylor, Michigan
Didn't find what you're looking for? Search again!
Loading more jobs...