Patient Experience Financial Navigator (Cancer Care Center)
Job Description
Job DescriptionDescription:
JOB SUMMARY
Under the general direction of the Patient Access Manager and the Patient Access Director, the Patient Experience Financial Navigator will assist non-emergent patients with financial planning. This role involves registering patients for services, maintaining accurate documentation, verifying insurance coverage, and accepting payments in compliance with standards set by The Joint Commission, as well as federal, state, and local regulations, and organizational policies and procedures. Additionally, the navigator will assess patients seeking financial assistance through external foundations, organizations, and grants. They will also evaluate patients for co-payment assistance programs offered by pharmaceutical companies, based on their diagnoses and prescribed medications. Effective communication with medical staff, other departments, and outside agencies is essential while maintaining patient confidentiality. This position requires self-motivation, creativity, and the ability to work independently in a fast-paced and dynamic environment.
STANDARDS OF PERFORMANCE
1.Performs registration for all patients presenting for service.
2.Obtains, inputs, and transcribes accurate patient data.
3.Completes necessary forms, including proper documentation/signatures and insurance information, either on paper or electronically.
4.Enters data into the computer with minimal errors.
5.Performs as a cashier for payments and maintains cash receipts with accuracy.
6.Notifies various departments that a patient needing their services has cleared registration.
7.In emergent situations, notify the emergency department that a patient is present for services in the Cancer Care Center and requires emergency care.
8.Meets non-emergent patients to discuss treatment and financial options for EHS and Summit Cancer Care Center Effingham location.
9.Explain helping hands and Medicaid applications when needed, referring all information to the business office.
10.Assesses insurance status. Verifies insurance benefits. Calculates and collects appropriate estimated liability from patients on services rendered or to be rendered.
11.Obtain payment of applicable co-payments, deductibles, and/or co-insurance according to health plans.
12.Discuss financial obligations and referral options with uninsured patients as per policy.
13.Sets up financial agreements according to hospital guidelines for any balance due.
14.Explains the Helping Hands program option, if applicable.
15.Scans all records into electronic medical records.
16.Screen all patients presenting for treatment for eligibility for financial assistance through foundations and co-pay assistance programs based on patient diagnosis, drug regimen, and ability to pay; complete all applications and follow-up required to maintain the patient's eligibility in the program; and add programs as secondary insurance into the hospital electronic record for billing purposes.
17.Obtain current and complete records of required spreadsheets and information instructed by the Patient Access Manager.
18.Provides Advance Directives to all patients as per hospital policy/procedure.
19.Acts as an ambassador for the facility by interacting with clients, family members, and staff in a friendly, caring, professional manner.
20.Requires completion of Patient Access certifications, Patient Access Specialist, and Financial Counselor certification with Hometown Health.
21.Requires completion of the Presumptive eligibility certification.
22.Ensures adherence to proper infection control, OSHA, and safety standards.
23.Provides support for other team members when needed and promotes a positive teamwork environment.
24.Performs other duties as assigned/needed/required within the scope of the job and training.
Requirements:
Minimum Level of Education: Education level equivalent to completion of High School. Completion of a Medical Biller curriculum is preferred.
Formal Training: Working knowledge of health insurance, deductibles, co-pays, and co-insurance, and a comfort level with out-of-pocket collections activities, as well as a thorough understanding of the accuracy needed to capture demographic and third-party payer information.
Licensure, Certification, Registration: Financial Counselor and Billing Specialist certification through Hometown Health will be required within the first 90-days of employment.
Work Experience: Minimum of 12 months (1 year) experience as a healthcare insurance biller or completion of a medical biller curriculum.
Tools and Equipment Used:
Calculator, personal computer, telephone, facsimile machine, paper shredder, copier, printer