Patient Advocacy Representative

The Alliance Solutions Group of companies is made up of several individual full-service recruitment and staffing agencies.

The Patient Advocacy Representative organizes inpatient and outpatient claims for electronic or hardcopy mail and forwards to appropriate third party payers for payment processing. Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing through payment of the claim, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary. Responsible for analysis of denied reimbursement claims. Ensures appropriate insurance coverage for compliance standards and revenue generation. Coordinates with departments and insurance companies to correct errors as necessary.

- Answer incoming telephone and email inquiries. Review case history and insurance notes to provide information to individual. - Call insurance companies to obtain information needed to resolve case issues. - Call physicians to obtain information or provide information pertaining to a case or issue. - Communicate results of a benefit investigation to patients and physicians. - Pre-qualify patients for any available financial assistance. - Respond to inquiries within the time standards established and complete work list tasks timely. - May undertake special projects assigned by the Billing Manager. - Initiate appeals or patient billing process when needed. - Participate in team meetings by sharing the details of cases worked. - Duties as assigned by manager, including typing, filing and answering phones.

**Education/Experience:** - High school degree or GED - Minimum of four years Health Insurance Billing experience. - Knowledge of managed care industry payor structures, rules and government payors. - Process superior customer service skills. - Ability to listen and work well with others. Detail oriented. - Possess excellent written and verbal communication skills - Able to establish priorities, work independently, and proceed with objectives without supervision. - Proficient in using Microsoft Excel and Word. ***Skills:*** - Excellent phone skills - Excellent phone voice - Solid PC experience - Good logical reasoning skills - Strong interpersonal skills - Social Perception skills - Active Listening - Strong data entry skills - Strong customer service skills - Ability to manage difficult people - Ability to manage objections - Assertiveness