Financial Advocate

Gillette Children's is seeking a Financial Advocate to join out team! 1.0 FTE (40hrs/wk) Monday - Friday, 8:00am - 4:30pm. This position will require initial on-site training, and then will transition to a remote working role.

** This is a remote opportunity; however, the selected candidate must reside in Minnesota or Wisconsin and have the ability to work onsite in St. Paul, MN as needed. **

Purpose of Position

This position exists as a resource for patients, families and the care team by ensuring coverage for all Gillette Services. The financial advocate assesses the financial profile of patients receiving services through financial screenings, providing patient estimates, and notifying patients about financial assistance options in addition to answering financial coverage questions and concerns both pre and post service.

Specific duties are determined by the work setting or patient population served. However, in all positions, the financial advocate will serve patients with challenging and complex conditions and will be required to work in highly coordinated teams. Care is organized around each patient’s condition which requires staff at multiple levels and across many departments to exhibit exceptional teamwork qualities including communicating efficiently and effectively and adopting the behaviors required for high functioning integrated teams.

Compensation and Benefits

The hourly wage for this opportunity is $23.18 to $32.72, with a median wage of $27.27/hour. Pay is dependent on several factors including relevant work experience, education, certification & licensure, and internal equity. Hourly pay is just one part of the compensation package for employees. Gillette supports career progression and offers a competitive benefits package that includes a retirement savings match, tuition and certification reimbursement, paid time off, and health and wellness benefits for .5 FTE and above.

Core Responsibilities and Duties

Information – Finds, effectively uses and provides information when requested. Readily adjusts to shifting priorities and work assignments.

Collaborates with Social Work team to connect patient with resources and provide content expertise regarding coverage for services.

Assist and educate patients and/or families with a host of services to ensure the process of collecting payments is fully explained and is as comfortable as possible. Explains Gillette’s billing model to ensure understanding of billing and expenses.

• Assess patient financial profile, determining whether the patient is eligible for charity care or other programs.
• Utilize all available resources (technology/people) to optimize the patient experience.
• Apply knowledge of insurance plans to verify insurance coverage and eligibility and payer requirements.
• Obtains/updates and documents patient demographic, financial and medical information, with a high level of accuracy for the provision of services, and is accountable to provide quality, complete and timely prior authorization of patient services to maximize financial return to Gillette Children’s Specialty Healthcare.
• Serves as an escalation resource for other team members regarding revenue cycle related concerns.

Accurate and Efficient Work – Demonstrates accuracy, efficiency and completeness in products and processes. Performs tasks with appropriate urgency and accuracy while reducing waste through proactive time management.

• Completes all required components to ensure coverage of Gillette services including financial counseling and estimate development.
• Demonstrates effective and timely management of assigned work queues and areas of responsibilities.
• Consistently follows all current department and organizational guidelines and workflows.
• Takes initiative and is proactive in use of time and project completion
• Identifies opportunities for improved workflow.
• Maintains the highest standard of patient confidentiality.
• Maintains a calm, warm and professional demeanor while interacting with others (telephone and in person). Uses de-escalation techniques in stressful situations.

Competence in Technology Required of the Position – Demonstrates understanding of the tools and systems needed to accomplish work.

• Demonstrates competency in organizational systems including: electronic medical record, office equipment, online resources, and other relevant technology to perform all necessary job functions.
• Proactive use of technology. Leverages automation and tools to improve efficiency and quality of work.

Procedure and Policies – Follows established procedures and policies. Protects the confidentiality of personal health information.

Adheres to all organization and department policies, guidelines, workflow to eliminate errors in practice.

• Adheres to organization and department attendance policy.
• Active Engagement – Be actively involved.
• Is on time for work and ready at start of shift.
• Attends and is engaged in team meetings
• Demonstrates a positive approach to work.
• Initiates goal development, consults with leader, and enters into HR system.
• Completes self-assessment timely and with contributing comments.

Completes all mandatory annual requirements within established timeframe.

Qualifications

Required

• High School Diploma/GED
• 3 years’ experience in customer service with at least one year in a healthcare setting
• Experience working with commercial and government insurance carriers and insurance forms

Preferred

• Experience with Medical Audits and Appeal submission
• Experience with hospital-specific computer systems

Knowledge, Skills and Abilities

• Intermediate understanding of hospital billing requirements and understanding of Explanation of Benefits (EOB), Contract Language, and Commercial and Government Payer Requirements
• Understanding of HCPCS/CPT Coding
• Knowledge and understanding of medical terminology
• Ability to problem-solve and address customer service concerns independently
• Desire to work directly with patients/families, exceptional telephone etiquette
• Ability to build relationships with patients, providers, insurance payers, and peers
• Conflict resolution and de-escalation skills

At Gillette Children’s, we foster a culture where every team member feels a sense of belonging and purpose. We are dedicated to building an environment where all feel welcomed, respected, and supported. Our values are embedded at the heart of our culture. We act first from love, embrace the bigger picture, and work side-by-side with our patients, families, and colleagues to help every child create their own story. Together, we work to ensure patients of all backgrounds and abilities reach their full potential.

Gillette Children's is an equal opportunity employer and will not discriminate against any employee or applicant for employment because of an individual's race, color, creed, sex, religion, national origin, age, disability, marital status, familial status, genetic information, status with regard to public assistance, sexual orientation or gender identity, military status or any other class protected by federal, state or local laws.

Gillette Children’s is a global beacon of care for patients with brain, bone and movement conditions that start in childhood. Our research, treatment and supportive technologies enable every child to lead a full life defined by their dreams, not their diagnoses.

To learn more about working at Gillette Children's, please visit https://www.gillettechildrens.org/careers.

Gillette Children's participates in the U.S. Department of Homeland Security (DHS) E-Verify program which is an internet-based employment eligibility verification system operated by the U.S. Citizenship and Immigration Services. If E-Verify cannot confirm that you are authorized to work, Gillette will give you written instructions and an opportunity to contact DHS or the Social Security Administration (SSA) to resolve the issue before Gillette takes any further action. Please visit https://www.e-verify.gov/ for further details regarding e-verify.