Patient Advocate

This is a fully remote position, open to applicants in India.

📋 Description

• Oversee both incoming and outgoing patient communications concerning medical bills, insurance claims, account balances, payments, reimbursement inquiries, and claim statuses.

• Inform patients about their insurance benefits, deductibles, co-pays, co-insurance, and out-of-pocket responsibilities.

• Clearly and professionally articulate account activities and available resolution options.

• Maintain a compassionate, patient-centered approach during delicate financial discussions.

• Respond to patient calls and emails in accordance with established service-level agreements.

• Investigate and resolve billing and balance issues by examining account notes, claim statuses, payment postings, and communications from payers.

• Work in collaboration with Accounts Receivable, Billing, Coding, Credentialing, and Account Management teams to address complex patient concerns.

• Provide assistance with claim follow-ups, appeals, reconsiderations, and patient correspondence.

• Record patient interactions, account activities, resolution efforts, follow-up initiatives, and account updates in Benchmark and other designated systems.

• Ensure that documentation aligns with company standards for quality, accuracy, and compliance.

• Supervise patient phone queues and service channels during assigned shifts.

• Accurately and efficiently process assigned printing and mailing requests.

• Review outstanding patient issues and collaborate with AR and operational teams for timely resolutions.

• Participate in team meetings, quality reviews, and training sessions.

• Identify trends in patient inquiries and relay potential process-improvement opportunities.

• Comply with HIPAA regulations, patient privacy requirements, U.S. healthcare compliance standards, payer guidelines, and company policies.

• Complete all necessary compliance, security, and customer service training.

• Escalate payer, coding, or reimbursement issues to the relevant departments.

• Contribute to goals related to patient experience, revenue cycle performance, and operational excellence.

• Meet expectations for productivity, quality, call handling, response time, follow-up, issue resolution, and patient satisfaction.

⛳️ Requirements

• Bachelor's degree preferred or equivalent experience in healthcare revenue cycle.

• A minimum of 3 years of experience in U.S. healthcare Revenue Cycle Management (RCM), medical billing, accounts receivable, patient services, or related healthcare operations.

• Preferred experience in supporting U.S. healthcare providers, physician groups, hospitals, or healthcare outsourcing organizations.

• Experience managing patient billing inquiries and insurance-related issues.

• Familiarity with working with U.S.-based healthcare clients from an offshore delivery center.

• Knowledge of healthcare practice management systems, EMRs/EHRs, and RCM platforms.

• Understanding of denial management, appeals processes, and payer follow-up methodologies.

• Prior experience in patient advocacy, customer service, or healthcare call center environments supporting U.S. healthcare operations.

• Strong grasp of U.S. healthcare revenue cycle workflows, including patient registration and eligibility verification, insurance verification and benefits review, medical billing and claim submissions, payment postings and reconciliations, accounts receivable follow-up, denials and appeals management, and patient collections and financial responsibilities.

• Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.

• Familiarity with medical terminology, CPT, ICD-10, and HCPCS concepts is preferred.

• Exceptional verbal and written English communication skills; ability to speak clearly, fluently, and professionally in English.

• Strong analytical, problem-solving, and customer service capabilities.

• Ability to work independently while managing multiple priorities.

• Willingness to work night shifts.

🏝️ Benefits

• Annual Public Holidays as applicable.

• 30 days of total leave per calendar year.

• Mediclaim policy.

• Lifestyle Rewards Program.

• Group Term Life Insurance.

• Gratuity.