At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
Bright Health is tripling its footprint in 2019 to offer a variety of health insurance plans to more individuals. Bright Health operates health insurance offerings across Individual and Family Plan segments and the Medicare Advantage space in Alabama, Arizona, Colorado, Ohio, New York and Tennessee.
We're Making Healthcare Right. Together.
SCOPE OF ROLE
The Patient Financial Services Advocate is our members' primary point of contact to help navigate and fight health care bills that they have received from hospitals and providers after the member has received out-of-network care. Bright Health's model guides members to in-network local care partners to ensure affordable and high-quality healthcare.
However, some members may receive care at out-of-network facilities in emergency situations. Bright Health covers members' episode of care in these emergency situations. Unfortunately, in most states, hospitals and providers are free to bill emergency, out-of-network patients over and above what they have already received as reimbursement. Sometimes, hospitals and providers bill more than ten or twenty times (or more!) what they readily accept in reimbursement in other situations.
Bright Health aims to break this cycle by standing up to these billing practices. The Patient Financial Services Advocate will play an important Bright Health role in this initiative.
The Patient Financial Services Advocate is a unique individual who possesses a unique blend of financially savviness and empathy a social worker at heart who can stand toe-to-toe to power. We need someone who has a nuanced understanding of hospital billing practices and who will help our members to fight back against unreasonable financial demands. As our member's primary point of contact, the Patient Financial Services Advocate will be the face of Bright Health working with our members at one of their most vulnerable and frightening moments. The Patient Financial Services Advocate will help members to understand the bills, what they owe, what's reasonable (and what's not), and then help the member to push back.
You will support members with high touch counsel including but not limited to: Listen, assess and understand the issues at hand.
Assist members in navigating complex billing practices. Set clear expectations with members around complexity of the circumstances, time commitment to resolve and potential outcomes to expect. Provide exceptional service to the member, including step-by-step resolution support.
Guide the member on how to effectively push back. Coordinate with Bright Health clinical professionals and vendors who are helping optimize patient care to help ensure the member continues to get the care they need. Lead negotiation and execution of resolution agreements with facilities and providers.
Advocate for and protect members with effective "hold harmless" language. Coordinate legal support for member when negotiating with facilities and providers. Provide the member with tools and messages to fight back.
Engage legal counsel when appropriate. As Bright Health grows, further develop, institutionalize, and standardize scalable processes. Track state and federal regulatory changes impacting hospital billing practices
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
A Bachelor's degree in Health Care Administration, Communications, Social Work or a related field is preferred
Four (4) or more years' experience in the healthcare industry navigating relationships around providers and insurance networks is preferred.
Four (4) or more years' experience in a related field demonstrating empathy and understanding while championing the individual is required.
Experience working in a highly regulated industry and familiarity with the legal process is required.
Strong verbal and written communication skills
Empathy for members experiencing fear after unexpected exposure to the healthcare system
Ability to negotiate in trying circumstances
Knowledge of and analytical skills to understand and apply regulatory guidance
Detail oriented and structured thinker with proven ability to simultaneously manage multiple cases across different geographies
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc.
But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.