Patient Financial Advocate

Join us at Transformations Care Network (TCN), as we embark on an exciting journey to empower individuals like you to make a difference in the field of behavioral health. We are committed to improving accessibility while raising the standard of care.

The Patient Financial Advocate  reports to the Patient Services manager, and serves as the primary point of contact for patients regarding billing statements, account balances, and payment options. This role is responsible for answering inbound patient calls, providing clear and compassionate financial explanations, resolving account inquiries, and facilitating timely payment arrangements.

This position plays a critical role in enhancing patient financial experiences while supporting the organization’s revenue cycle performance.

Key Responsibilities:

Patient Support and Account Resolution

• 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.

Financial Communication and Education

• 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

Documentation and Compliance

• 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

Performance and Metrics

• 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

This position has no supervisory responsibilities. Occasional Overtime is required as needed for departmental requirements.

Qualifications:

• 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 (Preferred)
• Prior call center or high-volume inbound call experience. (Preferred)
• Knowledge of payment plan structures and financial assistance policies. (Preferred)
• Familiarity with revenue cycle workflows from charge entry through payment posting. (Preferred)
• Certified Revenue Cycle Representative or other billing certification (Preferred)

Explore the Advantages of Joining Our Team:

• Enjoy competitive compensation and a wide range of benefits, including medical, dental, vision, low-cost virtual care, dependent and domestic partner coverage, 401K, and more, designed to support your well-being and financial security.
• Immerse yourself in a community united by a deep commitment to enhance mental health and revolutionize patient care.
• Embrace a journey of continuous learning, guided by seasoned professionals, fostering your career growth in a nurturing environment.
• Play a pivotal role in reshaping behavioral health, with your efforts directly improving patient lives.
• Thrive in an environment that celebrates collaborative success, driven by effective communication and unity.
• Receive comprehensive onboarding and ongoing educational resources, tailored to cultivate your talents and assure your triumph in your role.

Transformations Care Network is committed to fair and equitable compensation practices. The hourly compensation range for this role is $21 - $24. Actual compensation may vary based on licensure, experience, market-driven enhancements, and incentive opportunities available for this role. These ranges represent our current standard compensation practices and may be adjusted over time to remain competitive and aligned with organizational needs.

Transformations Care Network is an equal opportunity employer, committed to fostering an inclusive and diverse workplace.

Remote work eligibility: This position is open to candidates across the United States. Based on TCN's current employment requirements, this role is not eligible to be performed in California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Minnesota, Montana, New Jersey, New York, Oregon, or Puerto Rico. Eligible work locations are subject to change.