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Patient Advocacy Specialist

Company: Prime Health Service Inc
Location: Franklin
Posted on: September 18, 2022

Job Description:

The Patient Advocacy Specialist position reports to the VP of Patient Advocacy and works collaboratively with Prime Health Services' clients and referred patients to ensure timely scheduling of patient appointments consistent with their requests and defined treatment plan. This position refers cases, where in-network providers are not available in the desired geographic area, to the Provider Negotiation Specialist or the Provider Contracting team to secure a single case agreement with an appropriate provider. With a primary focus to deliver quality customer service to the patients and clients served, this position must demonstrate excellent communication, documentation, and follow-up skills throughout the management of each assigned case. Essential Job Functions

  • Schedules medical appointments in the PHS scheduling tool as requested and directed by PHS clients and the referred patients in a timely manner
  • Updates case status in the PHS scheduling tool with accurate and current information
  • Updates Client regarding status (balance of dollars allotted to each case) when patient expenses are nearing the maximum allotment to receive direction as to next steps, i.e. increase allotted dollar amount assigned to the case or close the case
  • Refers out-of-network providers to the Provider Negotiation Specialist to obtain a single case agreement and to the Provider Contracting team to contract the provider to the PHS network

    • High School Diploma or equivalent (GED) and 2 years of experience working in a healthcare, insurance, claims processing, and/or medical billing/pricing setting.
    • Certification from a recognized Medical Assistant training program is preferred
    • Prior patient scheduling, billing, and insurance verification experience is preferred
    • Demonstrated proficiency in Microsoft Office - Excel, PowerPoint, Word, MSTeams)
    • Bilingual (English/Spanish) preferred Competencies
      • Detail focused and the ability to multi-task and adhere to established goals
      • Ability to work in a fast paced, changing environment; flexible to meet business needs
      • Results driven team player
      • Ability to maintain confidential information as required
      • Excellent communication skills (oral and written)
      • Superb organizational, problem solving, and time management skills
      • Ability to maintain a calm and professional demeanor in stressful situations Physical Requirements This position requires light work - defined as, exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly. However, this position is typically performed in a seated position with no pulling or pushing or use of leg controls. Who We Are Prime Health Services is a national medical cost containment company offering a PPO network to the workers' compensation, group health, corrections, and auto liability markets. Our preferred provider network has been expanding since 2001 and now has over 800,000 medical providers and health care facilities nationwide with over 900,000 locations. The Prime Health Services PPO Network is available to insurance carriers, third-party administrators (TPAs), self-insured employers, governmental entities, corporations, and associations. We look for candidates who build a culture of teamwork and positive results. To be successful at Prime, you need to be forward-thinking, have an innovative spirit, be empowered to do your job well, act collaboratively, and be reliable. We're a company on the move and strive for excellence in everything we do! If this sounds like you, please submit your application today or pass this along to anyone who is searching for their next role with a growing company. PI190924834

Keywords: Prime Health Service Inc, Franklin , Patient Advocacy Specialist, Other , Franklin, Tennessee

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