CARLSBAD, NM, 88221, USA
17 days ago
Patient Advocate
**Job Summary** The Patient Advocate assists patients in navigating insurance, clinical clearance, and pre-authorization requirements to facilitate timely access to surgery and other medical services. This role acts as a liaison between patients, families, and healthcare providers, verifying insurance benefits, obtaining necessary authorizations, and providing information from a patient-centered perspective. The Patient Advocate enhances the patient experience by addressing questions and concerns pre- and post-operatively, supporting effective communication, and promoting patient rights and well-being throughout their care journey. **Essential Functions** + Assists patients in meeting insurance and clinical clearance requirements to expedite access to surgery and other procedures, including pre-determination and pre-certification approvals. + Verifies insurance benefits, guides patients through pre-authorization requirements, and collaborates with insurance providers to secure necessary approvals. + Acts as a resource for patients, providing information and support from a patient-centered perspective before and after surgery. + Facilitates communication between patients, families, and healthcare providers to ensure understanding of procedures, expectations, and available resources. + Educates patients and families about their rights, responsibilities, and available resources to support informed decision-making. + Investigates and resolves patient questions or concerns, coordinating with relevant departments to find solutions and provide timely follow-up. + Maintains accurate, confidential records of patient interactions, insurance authorizations, and approvals. + Performs other duties as assigned. + Complies with all policies and standards. **Qualifications** + 1-2 years of experience in patient advocacy, insurance navigation, or a healthcare support role, preferably in a surgical or clinical setting required **Knowledge, Skills and Abilities** + Knowledge of patient rights, healthcare policies, insurance benefits, and pre-authorization processes. + Strong communication and interpersonal skills for effective interaction with patients, families, and healthcare staff. + Problem-solving skills to address patient concerns and navigate insurance requirements promptly. + Empathy and resilience to provide compassionate support to patients pre- and post-operatively. + Organizational skills to manage multiple patient cases, maintain accurate records, and ensure timely authorization approvals. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.
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