Patient Advocate
On-siteKing of Prussia, Pennsylvania, United States
Job Summary
Own the patient complaint and grievance process from initial receipt through final resolution. Serve as the primary point of contact for all patient concerns by contacting individuals to acknowledge issues, gather information, and maintain communication throughout investigations. Collaborate with physicians, Compliance, and Risk Management to identify, escalate, and report potential compliance or patient safety issues. Conduct investigations by interviewing patients, staff, and reviewing medical records to prepare detailed summaries for leadership review. Draft written determination letters communicating findings and outcomes to patients while ensuring grievances are resolved within established timeframes. Maintain accurate documentation in a tracking system and monitor trends to recommend operational improvements. Maintain strict confidentiality in compliance with HIPAA and CMS requirements.
Required Qualifications
- Degree in Healthcare Administration, Nursing, Business Administration, Communications, Public Health, or a related field preferred but not required
- Minimum of three (3) years of experience in healthcare, patient relations, physician practice operations, or healthcare administration
- Knowledge of patient relations principles and service recovery best practices
- Knowledge of physician practice operations and outpatient healthcare workflows
- Knowledge of HIPAA, patient privacy regulations, and healthcare compliance requirements
- Knowledge of Microsoft Office applications and electronic medical record (EMR) systems
- Excellent verbal and written communication skills
- Strong customer service and interpersonal skills
- Skill in conflict resolution and de-escalation
- Skill in conducting investigations and documenting findings
- Skill in preparing professional correspondence and written determination letters
- Skill in organization, prioritization, and time management
- Skill in problem-solving and critical thinking
- Skill in collaborating effectively with physicians, management, and staff
- Skill in maintaining professionalism, objectivity, and confidentiality
- Ability to independently manage patient complaints from receipt through final resolution
- Ability to investigate concerns objectively and make sound recommendations
- Ability to establish and maintain effective working relationships with patients, physicians, management, and staff
- Ability to communicate effectively with individuals in emotionally charged situations
- Ability to analyze complaint trends and recommend operational improvements
- Ability to exercise sound judgment while maintaining confidentiality
- Ability to manage multiple priorities while meeting established response deadlines
- Normal office and outpatient clinical environment
- Requires sitting, standing, walking, and occasional bending associated with a normal office environment
- Requires manual dexterity for computer and telephone use
- Requires the ability to manage emotionally charged conversations and sensitive situations with professionalism, empathy, and sound judgment
- HOPCo's Mission, Vision, and Values must be acknowledged and adhered to
Desired Qualifications
- Experience investigating and resolving patient complaints or grievances preferred
- Experience working in a multi-site physician practice or outpatient healthcare setting preferred
- Experience collaborating with physicians and multidisciplinary healthcare teams preferred
- Knowledge of CMS patient grievance requirements and complaint resolution processes preferred
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