Patient Financial Advocate (Qualify Health)

• Identify patients who are eligible for philanthropic aid programs by reviewing patient financial and clinical information against established program criteria.
• Enroll eligible patients in philanthropic aid programs, including Patient Assistance Programs, copay cards, and foundations and grants, by accurately preparing and submitting applications to secure funding.
• Work with hospital staff and patients to gather all necessary documentation, and serve as a financial resource for patients throughout the advocacy process.
• Discuss advocacy options directly with patients, answer their questions, and explain available programs, procedures, and services using appropriate medical and administrative knowledge.
• Communicate with clinical and billing staff at hospital oncology practices and infusion centers to coordinate patient cases.
• Complete and manage post-enrollment work, such as submitting claims and ordering medications.
• Order, receive, and log medication orders, including free drug, coordinate timely medication deliveries to the designated pharmacy, and document accordingly.
• Appeal patient assistance denials and escalate unresolved issues as needed.
• Complete prior authorizations for specialty pharmacy medications and report outcomes to the client.
• Collaborate with the healthcare facility and billing department on advocacy collections and other medical billing functions, confirming that all advocacy has been collected and reflected on the patient's bill.
• File and maintain complete, accurate case records and supporting documentation in the designated electronic systems.
• Maintain working knowledge of the financial advocacy services, programs, and resources available to client patients.
• Place and receive patient calls using the virtual telephone application, including calls to request additional information, provide award status updates, and follow up on copay card and foundation claim status.
• Transmit information and documentation to patients, clients, foundations, and manufacturers by computer, mail, or virtual fax, and document updates and award status in the appropriate systems.
• Listen to and support patients experiencing financial hardship, and escalate client-related concerns to the assigned leader.
• Serve as a day-to-day point of contact for assigned client accounts, responding to routine inquiries and coordinating case updates within established service standards.
• Provide exceptional customer service to patients and clients in every interaction.
• Prepare and maintain records, reports, and files, including program and financial reporting.
• Review operational and program reports for accuracy and to confirm that client and organizational goals are being met.
• Represent the organization at company-scheduled events to share information about available services; travel may be required.
• Provide coverage for other support staff during absences as organizational needs arise.
• Attend staff meetings and consult with leadership on case, process, and workflow questions.
• Contribute to the growth and development of the company's mission.
• Maintain patient confidentiality and comply with HIPAA and all applicable federal, state, and client-specific requirements.
• Regular and timely attendance.
• Other duties as assigned.

• High school diploma, GED, or high school equivalency certificate required.
• Direct experience applying for manufacturer Patient Assistance Programs and manufacturer copay cards is essential for this position.
• Minimum 1 year of experience with manufacturer copay cards.
• Minimum 1 year of experience with Patient Assistance Programs.
• Minimum 1 year of experience in foundation support.
• Minimum 3 years of EMR experience, including Epic; Cerner and Meditech experience preferred.
• Minimum 2 years of medical oncology experience, including oncology-related experience within financial advocacy.
• Experience working directly with patients with cancer.
• Previous experience in healthcare, patient financial services, or a medical office setting preferred.
• Experience with prior authorizations and specialty pharmacy preferred.
• Proven experience in a high-performance, high-accountability environment.
• Working knowledge of administrative and clerical procedures, including word processing, spreadsheets, records management, and standard office practices.
• Proficient computer skills, including the Windows operating system, and strong proficiency in Microsoft products, specifically Outlook, Teams, and Excel, along with Word.
• Ability to learn additional electronic medical record systems such as Athena, Paragon, or Aurora, and client financial advocacy portals.
• Excellent verbal and written communication skills in English and strong listening skills, including accurate documentation and professional correspondence with patients, clients, and external programs.
• Bilingual in English and Spanish preferred.
• A genuine passion for helping patients, with the ability to offer emotional support and empathy and to interact calmly with patients who may be upset, confused, or experiencing financial distress.
• Basic mathematical and analytical skills sufficient to review financial information and program award data for accuracy.
• Meticulous attention to detail, with the ability to follow structured workflows while managing competing priorities and deadlines.
• Self-starter who can work independently and collaboratively within a remote team environment.
• Understanding of HIPAA requirements and the appropriate handling of confidential patient and financial information.
• Access to a distraction-free home office environment.
• Ability to pass a standard background check.

ElevatePFS believes in making a positive impact not only within our industry but also with our employees – the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.

The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.