The Patient Care Advocate (PCA) serves as the primary liaison between patients, therapists, referring providers, and payers to support the coordinated delivery of rehabilitation services. Ensures efficient scheduling, insurance verification, registration, and authorization processes while maintaining accurate documentation and compliance with payer guidelines. The PCA promotes a positive, patient-centered environment by addressing inquiries, communicating financial responsibilities, and facilitating continuity of care. Through proactive coordination and administrative oversight, the PCA supports operational efficiency and departmental growth.
ESSENTIAL FUNCTIONS:
- Serves as the primary coordinator of patient and therapist scheduling, answers and directs incoming calls and inquiries professionally, and responds to urgent situations.
- Maintains professional and patient-centered work environment by assisting staff with operational needs, including upkeep of equipment and shared spaces.
- Registers patients for rehabilitation services by collecting required information and signatures and reviewing patient financial responsibility at admission.
- Serve as the lead authorization and insurance verification specialist by coordinating with payers to determine patient eligibility for care.
- Maintain current knowledge of Medicare and Private/WC insurance guidelines and policies related to physical, occupational, and speech therapy services.
- Monitor and manage receipt of provider orders and signatures, follow up on deficiencies, assist therapists with required documentation signatures, and oversee incoming fax correspondence.
- Serve as primary scheduler for swing-bed and outpatient services maintaining the call list, filling schedule gaps, coordinating changes with the department manager, and resolving scheduling conflicts.
- At least three days prior to procedures, verify insurance and patient financial responsibility, obtain or update required registration information, document payment selections, and complete Schedule Registration documentation.
- Maintain neat, professional appearance while contributing to safe, patient-centered work environment and demonstrating commitment to teamwork, mentorship, and financial stewardship.
- Perform assigned duties efficiently and in accordance with instructions, maintain regular and punctual attendance, ensure proper shift handoff communication, and adhere to scheduling and overtime policies.
ADDITIONAL RESPONSIBILITIES:
- Other duties as assigned by the Director of Rehabilitation
JOB QUALIFICATIONS/EXPERIENCE/SKILLS:
Required:
- High school diploma or equivalent.
- Excellent communication skills, written and verbal.
Preferred:
- Experience in a medical insurance billing setting.
- Knowledge of medical terminology and insurance guidelines regarding rehabilitation authorization.
- Experience efficiently using a computer and accurately entering data.
WORKING CONDITIONS/ PHYSICAL REQUIREMENTS:
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift 15 pounds at times.
- Must be able to access and navigate each department at the organization's facilities.
DISCLAIMER: This job description may not comprise all duties that may be required to be performed. Management reserves the right to amend as needed.