Patient Access Advocate II - Emergency Department - CDS

Patient Access Advocate II – Emergency Department – CDS

Location: 1100 Central Avenue SE, Albuquerque, New Mexico , United States

Employment Type: Full time – Weekend Schedule (Friday–Sunday)

Summary: The Patient Access Advocate II registers patient accounts for government and commercial insurers for scheduled and unscheduled visits. Responsibilities include demographic updates, insurance verification, authorization collection, point‑of‑service liability documentation, and benefit analysis within the ADT system. The role ensures clean billing, accurate account registration, and high‑level customer service, while monitoring for duplication and compliance with Medicare and other regulatory guidelines.

• Provide an exceptional patient experience using CARES, AIDET, and EPE tools.
• Resolve complaints in the moment using de‑escalation techniques.
• Manage conflict and seek supervisor assistance when needed.
• Apply PROMISE and CARES behaviors in every encounter.
• Educate patients on insurance benefits and financial liabilities.
• Ensure accounts are financially cleared at the time of service.

• Perform patient registration, collecting accurate demographic and financial information.
• Obtain missing insurance information (policy, group, DOB, phone).
• Verify eligibility and benefits through electronic or direct payer contact.
• Confirm accurate policy IDs, group names, authorization numbers, and coordination of benefits.
• Document actions in the system of record for audit trails.
• Maintain knowledge of authorization requirements and payer guidelines.
• Accurately complete MSPQ during service when needed.
• Maintain daily productivity standards and recommend performance enhancements.
• Track the Data Quality program, correcting errors at the time of service.
• Maintain accurate records and documentation.
• Perform other duties as assigned.

• Collect patient financial obligations, including residual balances.
• Educate patients about financial assistance, charity programs.
• Refer to on‑site Financial Advocate or the Financial Advocacy Center as appropriate.

• Complete missing account information to ensure accuracy.
• Communicate patient liabilities transparently.

• Cooperate fully in risk management activities.
• Report suspected violations to laws and regulations.
• Conduct all transactions in compliance with company policies.
• Demonstrate knowledge of applicable compliance and legal requirements.

• Collaborate, be Accountable, Respect, Engage, and Serve to all encountered.

• High school diploma or GED required.
• 1 year of experience in Patient Access and/or billing with strong customer service background.
• Completion and passing of the Patient Access Advocate II Advancement test.
• CHAA, CHAM, or other industry certification preferred.
• Strong understanding of insurance and financial processing.
• Basic knowledge of medical terminology and billing codes (DRG, ICD‑10, CPT, HCPCS).
• Proficient in EPIC ADT system.
• Knowledge of the customer encounter process including registration, financial guidelines, and coordination of benefits.
• Ability to work independently and with diverse individuals.
• Effective communication, analytical, and problem‑solving skills.
• Proficiency in Microsoft Office products.
• Completion of a 2‑week Patient Access Academy with an 85% or higher passing score.
• Pass annual competency exam for all responsibilities.
• Attend staff meetings and employee forums.
• Updated 7/30/25.

AA/EOE/VET/DISABLED. PHS is a drug‑free and tobacco‑free employer with smoke‑free campuses.