Patient Care Advocate Jobs

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Patient Care Advocate

The Patient Care Advocate coordinates with the patients —and their loved ones — and helps navigate the health care system, scheduling medical visits, understanding the policy coverage, and liaise with the insurance operations to provide the utmost in quality case management and medical concierge services. They assist with many aspects of a patient's medical care to make it less complicated.

Expected Outcomes & Actions

1. MEDICAL CONCIERGE (75%)

1. Coordinate the patient’s care and address any questions regarding coverage.
2. Arrange specific appointments when necessary.
3. Arrange airport travel, hotel accommodation and other concierge services.
4. Meet patients at the airport and arrange premium assistance when necessary.
5. Work in conjunction with each hospital’s international department to coordinate the patient’s care.
6. On-Call to assist patients as needed after hour, and addresses the patients’ concerns, telephonically and in person
7. Bring concerns to department’s leaders, serving as a resource for interventions related to dissatisfied patients/families/corporate client
8. Always provide exceptional customer service skills.
9. Understand the policy coverage for the members
10. Make sure patients’ rights are met
11. Problem solver with attention to detail, service, integrity, and accountability
12. Generate reports and any data requests, as necessary.
13. Offer Translation services (Spanish only)
14. Availability to accompany the patients when required
15. Travel may be required for training purposes

2. CASE COORDINATION (25%)

1. Responsible to support the Case Management Service Levels
2. Prioritize cases and determines urgency and necessity of case management.
3. Coordinating service requests for the Corporate Clients
4. Work closely with the Customer Service, Managed Care, Account Management, and other departments when applicable
5. Refer the patient to the most appropriate provider based on cost and quality.
6. Verify all information obtained in the initial case notification.
7. Obtain in writing all necessary medical information required by Client to provide coverage confirmation.
8. Verify treatment meets medical criteria.
9. Setting an initial reserve, updated reserve and final reserve accurately
10. Verify charges are within Usual Customary and Reasonable (UCR)
11. Provide Options or alternative care when charges are not within UCR.
12. Review medical information to determine if further treatments are needed, review medical updates, and validate the policy wording.
13. Completes special assignments and projects instrumental to the function of the Case Management department.

Requirements and Qualifications

• Must exhibit strong communication skills and professionalism
• Capable and confident in negotiations and problems solving skills
• Working knowledge of Microsoft Office application and Internet
• Clear and effective communication in both English and Spanish (written and verbal)
• College Diploma
• 3+ years in healthcare related services
• Capacity to work with people in a fast-paced, team-based environment

Global Excel offers you a competitive salary, benefit package and performance bonus.

**Only the candidates based out of Houston, Texas will be considered for this role**