Patient Financial Navigator

Schedule: Day Shift. Hours will be 8:00am -4:30 pm Monday through Friday.

About the Position

This position has the responsibility for assisting patients and/or families access a variety of financial resources. This is accomplished by evaluating the financial situation of uninsured or under-insured patients in accordance with regulatory compliance while maintaining patient confidentiality and dignity.

Overview of Responsibilities

• Accurately details collection activity and makes appropriate recommendation for disposition of accounts for patients applying for financial assistance.
• Following directions from Eligibility vendor, interviews uninsured, under-insured or patients with questionable third-party coverage in a timely and appropriate manner. Explains the organization’s payment policy, use of eligibility vendor, government policy for discounts (501R), long term vendor for payment plan(s), and assists with financial assistance forms if applicable.
• Works closely with agencies and other departments to obtain assistance for patients unable to meet their financial responsibility.
• Follows up with agencies on patients referred for assistance to ensure that applications have been completed and that the patient is cooperating fully with agencies.
• Arranges monthly payment plans with patients who need an extended time to meet their obligations to the organization pertaining to inhouse payment plans and extended payment plans.
• Manages the monthly recourse report received from the extended payment plan vendor.
• Accurately completes applications for the Financial Assistance/Charity Care Program.
• Reviews accounts qualifying for the bad debt work queue to ensure the appropriate thresholds have been met prior to routing to the organization’s bad debt vendor.
• Responsible for managing accounts qualifying for the bankruptcy and estate work queues.
• Arranges and maintains payroll deductions for hospital employees as needed.
• Point of Service approval or denial procedures based on the patient’s willingness to cooperate with rules and collection policies.
• Assist appropriate patients and families to explore options for financial assistance for medical services with referral to Social Services when appropriate.
• Complete appropriate financial assistance forms to aid patients with medication costs.
• Attends Oncology New Patient Conference meeting in conjunction with the patient’s Care Team.
• Maintains a professional relationship and conveys relevant information to other members of the healthcare team within the organization and any applicable referral agencies.
• Obtains necessary insurance information from patients and answers questions or directs patients to appropriate staff members for questions regarding insurance, billing, payment, and/or collection arrangements.
• Meets with patients to discuss estimated costs of therapies within the Oncology service line.
• Follows compliance with all laws, regulations, and guidelines of federal and state programs with an emphasis on prevention of fraud, waste, and abuse.
• Position includes other duties and projects as assigned to support goals and outcomes consistent with department expectations.
• Actively participates in area and department meetings.
• Attends other meetings as requested.

This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities that management deems necessary.

Education & E xperience

• Education Required: High School Graduate or GED equivalent.
• Experience Required: Three-year previous experience in payment collection