Patient Care Advocate Jobs

Patient Care Advocate

The Patient Care Advocate coordinates with the patients, providers, and the rest of the company’s operation to provide the utmost in quality case management and medical concierge services.

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
7. Offer Translation services (Spanish only)

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.

Requirements and Qualifications

• 3+ years in healthcare related services
• Must exhibit strong communication skills and professionalism
• Available for travel, mostly in the US, 5%
• Capable and confident in negotiations and problems solving skills
• Clear and effective communication in both English and Spanish (written and verbal)
• College Diploma
• Working knowledge of Microsoft Office application and Internet
• 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**