Position Summary
The Care Management - Financial Advocate helps patients navigate the financial aspects of healthcare by ensuring they understand medical bills, insurance coverage, and financial assistance options. This role also involves pretreatment and post-treatment negotiations, as well as supporting patients through billing disputes and appeals processes.

Duties and Responsibilities
Insurance & Claims Support
• Explain health insurance policies, benefits, deductibles, copays, coinsurance, and indemnity reimbursements.
• Develop individual financial action plans and follow up on progress towards financial goals.
• Provide financial guidance and advocacy to clients regarding available financial assistance programs, benefits, and resources.
• Ensure claims are processed accurately and help resolve issues with insurers.

Billing & Payment Assistance
• Review and explain medical bills to identify errors or overcharges.
• Negotiate payment plans, discounts, or settlements with healthcare providers.
• Support patients with pretreatment and post-treatment financial arrangements.

Financial Counseling & Resources
• Assess patients’ financial situations to recommend appropriate payment options.
• Connect patients with financial assistance programs, charity care, or government subsidies.
• Educate patients on managing healthcare expenses and available support resources.

Patient Advocacy & Support
• Represent patients in disputes with providers or insurers regarding billing or coverage.
• Ability to maintain confidentiality and handle sensitive patient information in compliance with HIPAA Regulations.
• Provide compassionate support during financially stressful situations.

Qualifications and Skills
Required:
• Minimum 3 years of experience in healthcare financial counseling, billing, or claims.
• Strong knowledge of private insurance, Medicare, Medicaid, and payer systems.
• Ability to interpret medical bills, EOBs, and resolve billing discrepancies.
• Familiarity with financial assistance programs and subsidies.
• Proficiency with EHRs, insurance systems, telehealth platforms, and CRM tools.
• Excellent written and verbal communication skills.
• Strong analytical and problem-solving abilities.
• Must be legally authorized to work in the United States.
• Ability to successfully pass a background check.

Preferred:
• Associate’s degree in healthcare administration, finance, or related field.
• Experience in patient advocacy or hospital financial services.

Education
• High School diploma or equivalent (GED)

Work Environment Requirements
• Professional office environment with standard hours (Mon–Fri, 8am–5pm); occasional extended hours during peak times.
• Frequent use of computer, phone, and standard office equipment.
• Regular interaction with staff, leadership, and customers in a fast-paced, high-volume setting.
• Occasional standing, walking, and lifting of up to 15 pounds (e.g., supplies or equipment).