Financial Services Advocate

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization.

Candidates should reside in Pennsylvania. This role is remote based with weekly travel to clinics in the Pennsylvania area and 2 in NYC metro area.

SUMMARY

The Financial Services Advocate (FSA) supports insurance retention by providing direct patient education and collaborating with Social Workers and other center staff as needed to identify insurance options related to dialysis across multiple markets. The FSA focuses on all health insurance types, including Commercial, Supplemental, and Government-sponsored plans, such as Medicare, Medicare Advantage, Medicaid plans. This role carries out a range of educational, administrative, and reporting responsibilities to support corporate and regional teams while empowering patients to make informed decisions that align with their needs. The FSA takes a proactive approach to helping patients understand their benefits, delivering clear education, and minimizing coverage lapses.

Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.

• Deliver proactive patient education to improve understanding of benefits and reduce lapses in insurance coverage.
• Educate new patients with out-of-network (OON) benefits in accordance with the No Surprises Act to support informed decision-making.
• Complete an initial pre-assessment screening for new patients, identifying education needs and insurance coverage opportunities upon admission, or soon thereafter.
• Document all patient interactions in designated tracking system and complete assigned work list items timely.
• Support patients through life events that may impact their coverage choices. Examples include COBRA and transitioning to Medicare due to COB.
• Assist underfunded and unfunded patients by providing enrollment assistance, education, and referring to brokers when applicable.
• Submit actionable, detailed red flag insurance verification request for intake to verify insurance coverage and accurately update PEARL insurance coverage records Assist with insurance reinstatements as needed, including member appeals.
• Provide ongoing education and coordination regarding Medicaid and Medicare applications and renewal processes.
• Play a key role in open enrollment initiatives by educating patients on their choices, as well as educating our clinics and report findings
• Seek out and establish strong alliances with local brokers and insurance agents.
• Take an active role in helping support patients eligible for charitable premium assistance.
• Engagement in various financial assistance programs and special projects may be required at times. Programs can be internal or external. Partner with Social Workers through these processes.
• Participate in facility Operation meetings and present potential risks related to loss of insurance coverage
• Travel is required. Arrange in-person scheduled meetings at clinics within driving distance at least quarterly. Remote outreach for out-of-state markets is acceptable, but it's encouraged to use electronic meeting tools and travel to clinics in between visits.
• Responsible for staying informed of industry changes, and shares this information with the department management.
• Develop and maintain relationships through effective and timely communication
• Protect confidential information, always maintaining strict confidentiality.
• Promote GUEST customer service standards and build effective working relationships across all levels of the organization.
• Support a team-oriented environment and perform duties in accordance with company policies and procedures.
• Work to meet individual and team metrics and goals as outlined by management.
• Escalate coverage risks immediately and collaborate to resolve quickly.
• Maintain regular and reliable attendance.

Qualifications/Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

Requirements include:

• High school diploma or equivalent
• 2+ years of experience in a healthcare setting and prior customer service experience
• Bi-lingual language skills are a plus
• Thorough understanding of ESRD billing and COB rules
• Ability to multi-task, prioritize, and work independently
• Able to develop and present training materials when necessary
• Exceptional communication methods
• Intermediate working knowledge of Microsoft Outlook, Word, Excel, TEAMS
• Travel will be required as part of this position