Patient Advocate

Organization: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder Overview: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Patient Advocate to join our team! As two of the region’s most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. This is a full time Monday-Friday position. Position Summary: Responsible for managing the organization's patient complaint and grievance process frominitialreceipt through final resolution. Serves as the primary point of contact and voice of the practice for patients with concerns, complaints, or grievances by ensuring issues are investigated thoroughly, communicated appropriately, and resolved ina timely, professional, and compassionate manner. Coordinates with physicians, operational leadership,Compliance, Risk Management,and other departments tofacilitateinvestigations,identifyand escal...

ESSENTIAL FUNCTIONS

Serves as the primary point of contact for all patient complaints, grievances, concerns, and service recovery matters. Collaborate with Compliance and Risk Management toidentify, elevate, and report patient concerns, grievances, and potential compliance or patient safety issuesin accordance withorganizational policies and regulatory requirements. Owns the patient complaint and grievance process frominitialreceipt through final resolution. Receives, reviews, documents, and summarizes patient complaints for leadership review. Contactspatients to acknowledge concerns, gatheradditionalinformation, andmaintaincommunication throughout the investigation process. Serves as the voice of the practice by ensuring patients receivetimely, professional, compassionate, and consistent communication. Investigates complaints by interviewing patients, physicians, managers, andstaffand reviewing medical records and other relevant documentation. Coordinates investigations with physicians, practice managers, operational leadership, and other departments to ensure concerns are addressed appropriately. Escalates complaints requiringadditionalreview to theappropriate leadershipteam. Preparesdetailed investigation summaries for leadership review. Drafts written determination and resolution letters communicating investigation findings and outcomes to patients. Ensurespatient grievances are acknowledged, investigated, and responded to within established organizational and regulatorytimeframes. Maintainsaccuratedocumentation of all complaints, investigations, correspondence, and resolutions withinadesignated tracking system. Monitorscomplainttrends andpreparesrecurring reports for leadership toidentifyopportunities for operational improvement. Partners with leadershipto recommendcorrective actions and process improvements based on complaint trends. Collaborateswith physicians, clinical staff, and administrative staff to promote patient satisfaction and service excellence. Assistspatients in navigating the organization byfacilitatingcommunication between departments and connecting patients withappropriate resources. Maintains strict confidentiality andcomplies withHIPAA, CMS grievance requirements, and all organizational policies and procedures. Participates in patient experience initiatives, quality improvement projects, and special assignments as requested. Performs other duties as assigned.

EDUCATION

Degree in Healthcare Administration, Nursing, Business Administration, Communications, Public Health, or a related field preferredbut notrequired.

EXPERIENCE

Minimum of three (3) years of experience in healthcare, patient relations, physician practice operations, or healthcare administration. Experience investigating and resolving patient complaints or grievances preferred. Experience working in a multi-site physician practice or outpatient healthcare setting preferred. Experience collaborating with physicians and multidisciplinary healthcare teams preferred.

KNOWLEDGE

Knowledge of patient relations principles and service recovery best practices. Knowledge of physicianpracticeoperations and outpatient healthcare workflows. Knowledge of HIPAA, patient privacy regulations, and healthcare compliance requirements. Knowledge of CMS patient grievance requirements and complaint resolution processes preferred. Knowledge of Microsoft Office applications and electronic medical record (EMR) systems.

SKILLS

Excellent verbal and written communication skills. Strong customer service and interpersonal skills. Skill in conflict resolution and de-escalation. Skill in conducting investigations and documenting findings. Skill in preparing professional correspondence and written determination letters. Skill in organization, prioritization, and time management. Skill in problem-solving and critical thinking. Skill in collaborating effectively with physicians, management, and staff. Skill inmaintainingprofessionalism, objectivity, and confidentiality.

ABILITIES

Ability to independently manage patient complaints from receipt through final resolution. Ability to investigate concerns objectively and make sound recommendations. Ability to establishand maintain effective working relationships with patients, physicians, management, and staff. Ability to communicate effectively with individuals in emotionally charged situations. Ability to analyze complaint trends and recommend operational improvements. Ability to exercise sound judgment whilemaintainingconfidentiality. Ability to manage multiple priorities while meeting established response deadlines.

ENVIRONMENTAL WORKING CONDITIONS

Normal office and outpatient clinical environment. Occasional travel between practice locationsasneeded.

PHYSICAL/MENTAL DEMANDS

Requires sitting, standing, walking, and occasional bending associated with a normal office environment. Requires manual dexterity for computer and telephone use. Requires the ability to manage emotionally charged conversations and sensitive situations with professionalism, empathy, and sound judgment.

ORGANIZATIONAL REQUIREMENTS

HOPCo'sMission, Vision, and Values must be acknowledged and adhered to. #HOP Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr The CORE Institute