Patient advocate LPN

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.