Patient Advocate

Summary: This position is primarily responsible for helping our Secure Horizons & Evercare (Medicare Advantage) patients with complaints, service issues, and to optimize their plan benefits. This position helps patients over the phone and in person. The primary purpose is to attract and retain patients to the practice through excellent customer service.
Duties:

1. This position is primarily responsible for customer service related to specific Medicare advantage patients, though helps any GMG patient with service needs/issues.
2. Makes outbound Welcome calls and send out Welcome letters to all new Medicare Advantage patients monthly.
3. Schedules new patients for Intake visits from new enrollment lists.
4. Conducts outreach to educate patients regarding their health plan benefits, GMG services and Pt Advocate role.
5. Compares current specialists and prescription medications to network providers and formulary; help patient transition to plan specialists and formulary meds.
6. Assists patient to access value added services: transportation, vision services, hearing services, disease management programs, etc.
7. Supports marketing efforts by participating in select marketing events.
8. Receives inbound member calls to assist patients with health plan or care related issues.
9. Assists walk in members with health plan or service issues.
10. Assists patients/members with information about community resources available to support their healthcare/social needs.
11. Contact members who un-enroll monthly to survey reasons for leaving and identify opportunities to keep members at GMG
12. Maintain records of monthly enrollment, disenrollment
13. Accurately documents pertinent patient information in clinic practice management systems.
14. Assists providers and staff with questions regarding Medicare Advantage plans and benefits; coordinates and conducts training.
15. Maintains strictest member and company confidentiality.
16. Ensures member health information is secured each day.
17. Able to work efficiently under pressure.
18. Other duties as assigned.

Education and Experience: College Degree preferred - years of experience may be substituted for degree. Minimum 5 years' experience in a healthcare setting required. Must have previous customer relations, must have experience with Medicare Advantage plans or Referrals, familiar with a variety of the field's concepts, practices, and procedures. Excellent communications skills both Oral and written, ability to effectively communicate with varied audience, and bilingual in English/Spanish is strongly preferred.
Computer Skills: Knowledge of Word Processing software, database software, spreadsheet, and Internet software
Supervisory Responsibilities: This job has no supervisory responsibilities.
Work Environment: Depending upon the area assigned, may be 100% clinical setting or office setting in a clinical environment. Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a clinic environment.
Physical Demands: Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs. Close vision and ability to adjust focus.
The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor. Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions of the job.