Those working in Patient Advocate jobs work on behalf of a specific patient to navigate the complexities of the health care system. When illness strikes, it can often be overwhelming for an individual to focus both on the treatment needed to regain their health and the often bewildering bureaucracy of hospitals, private insurance companies, Medicare and Medicaid to ensure that necessary treatments are received and that procedures are covered.
Health care advocates work as a representative of the patient when dealing with health care providers and hospitals. In addition, they educate clients about insurance and their rights as patients, and intervene with HMOs, Medicare and other medical providers as needed. This may include assisting with referral for care and support for both patients and their families, and provide communication and coordination with all medical practitioners involved in a patient's care.
Advocates should be people-oriented and have plenty of patience. They need to understand how payer reimbursements work, including co-pays, co-insurances and deductibles. An understanding of Medicare and Medicaid, and basic math skills are also important.
Patient Advocate jobs may be found in insurance companies (usually HMO's), state health systems (in nursing or in a social work or human resources capacity), in a patient-focused organization such as the NPAF (National Patient Advocate Foundation), or by creating your own patient advocate job by starting your business.
Patient Advocates are also known as Claims Assistance Professionals (CAP), Medical Claim Advocates, Patient Billing Advocates, or healthy care advocate, all of which are sometimes used interchangeably.
Few accredited colleges offer degrees in patient advocacy; people interested in such work generally pursue associate's, bachelor's, master's or doctorate degrees in public health, social work, health care, or related medical fields and build their careers from there.
A thorough knowledge of the laws, policies and practices of managed health care is essential. The patient advocate must stay updated on laws and policies and treatment options.
Should the healthcare reform currently being considered by the Federal Government be implemented, the current information Medical Claim Advocates use to navigate the health care system may undergo certain changes.This may affect the way a patient advocate does his or her job, and additional training will probably be required.It is to your advantage to acquire experience working one on one with patients in a medical setting, which can be achieved through volunteering at a health care facility, coordinating services for patients, and also to get training with HIPAA (the Health Insurance Portability and Accountability Act).
After gaining some experience, a patient advocate might advance in a number of areas, including long term care and geriatric care, rights of the mentally ill, rights of victims of medical errors, patient education, and patients' rights. In addition, Advocates may advance to Case Managers; most case managers have nursing degrees or social work degrees and then take a test that makes them eligible for jobs that require the case manager credential. Most Case Managers are employed with managed care/HMO (health management organizations), or by government entities who work directly with patients.
With the complexity of our current health care system, as well as an aging population which will require increasing medical care, patient advocates will continue to be in demand. These up-and-coming patient advocate jobs should continue to increase at well above the national average for new job creation, making it a solid career option.
Medical Claim Advocates average $14.78 to $31.50 per hour , the low end indicating entry level jobs, and the higher end indicating an experienced worker.
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