Patient Advocate

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

📋 Description

• Oversee incoming and outgoing patient communications related to medical billing, insurance claims, account balances, payments, and reimbursement queries.

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

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

• Approach sensitive financial discussions with empathy and a patient-centered mindset.

• Respond to patient calls and emails within established service-level agreements (SLAs).

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

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

• Assist with claim follow-ups by assessing claim statuses and identifying obstacles to reimbursement.

• Provide support for appeals, reconsiderations, and patient correspondence as needed.

• Document patient interactions, account activities, and resolution efforts accurately in Benchmark and other designated systems.

• Maintain comprehensive records and ensure compliant account documentation.

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

• Process designated printing and mailing requests.

• Evaluate outstanding patient issues and coordinate timely resolutions with AR and operational teams.

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

• Recognize trends and communicate opportunities for process improvements.

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

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

• Escalate payer, coding, or reimbursement concerns as necessary.

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

• Achieve productivity, quality, call handling, response time, follow-up, claim, mailing, and patient support benchmarks.

• Exhibit strong issue resolution skills and achieve high patient satisfaction outcomes.

⛳️ Requirements

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

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

• Background in addressing patient billing inquiries and insurance-related matters.

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

• Familiarity with healthcare practice management systems, EMRs/EHRs, and RCM platforms.

• Knowledge of denial management, appeals processes, and payer follow-up strategies.

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

• Strong understanding of U.S. healthcare revenue cycle processes, including patient registration and eligibility verification, insurance verification and benefits analysis, medical billing and claim submission, payment posting and reconciliation, accounts receivable follow-up, denial 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 preferred.

• Outstanding verbal and written English communication skills, demonstrating clear, fluent, and professional English-speaking capabilities.

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

• Capacity to work independently while managing multiple priorities.

• Willingness to work the night shift.

🏝️ Benefits

• Annual Public Holidays as applicable.

• 30 days of total leave per calendar year.

• Mediclaim policy.

• Lifestyle Rewards Program.

• Group Term Life Insurance.

• Gratuity.