Financial Navigator, Case Management

ThedaCare-posted 24 days ago

Full-time • Mid Level

Onsite • Neenah, WI

5,001-10,000 employees

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Summary : The Financial Navigator role is responsible for guiding patients through their financial journey during their stay at the facility and immediately post discharge. The Navigator is assigned to a patient at the time of service and will be available up to 30 days post discharge. The Financial Navigator serves as the onsite point person for the patient. Key support function of the Financial Navigator includes, but are not limited to, triaging financial questions, providing patient education, performing onsite patient rounding, answering customer service calls, and facilitating process improvement projects for the patient’s financial journey.

Provide estimates of out-of-pocket costs for procedures, treatments, and services.
Discuss payment options and support patients in understanding their financial responsibilities.
Verify insurance eligibility and benefits prior to scheduled services.
Assist in obtaining prior authorizations and pre-certifications when needed.
Work with billing and registration staff to ensure accurate insurance information is captured.
Screen patients for eligibility for financial assistance programs (e.g., hospital charity care, Medicaid, ACA plans).
Assist with applications for public benefits, grants, or pharmaceutical assistance programs.
Collaborate with social workers and case managers to support underinsured or uninsured patients.
Help patients set up payment plans or connect them with billing specialists.
Maintain accurate, confidential, and timely documentation of all financial counseling activities.
Ensure compliance with hospital policies, federal regulations (like HIPAA), and financial assistance laws.
Track outcomes and generate reports for quality improvement and operational efficiency.
Offer culturally sensitive and compassionate support, especially during complex or critical care situations.
Work with multidisciplinary teams to ensure continuity of care while minimizing financial barriers.
Educate patients and families about resources and tools for managing healthcare costs.
Participate in hospital outreach initiatives or community events related to financial literacy or healthcare access.
Work with Patients and Families in navigating long-term care, Assisted Living, and other transitional care financial processes and/or application.
Research and responds to account inquiries in a timely manner
Knowledge of all aspects of the revenue cycle and processes to troubleshoot and resolve issues
Must demonstrate critical thinking, problem solving and knowledge of all the Revenue Cycle areas and processes to be effective in the position
Work with leadership team to implement workflow changes if appropriate
Communicate patterns and trends with other departments to improve work standards
Performs other duties as assigned

Bachelor’s degree or equivalent experience in Healthcare Management / Administration preferred
3-5 years of experience in multiple areas of the revenue cycle is preferred, including but not limited to a financial counselor role, customer service role, or other applicable roles
Prior customer service and/or hospital experience is a plus
CRCR required within 9 months of hire
Ability to move freely (standing, stooping, walking, bending, pushing and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
Position requires compliance with department specific competencies.

Lifestyle Engagement e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
Access & Affordability e.g. minimal or zero copays, team member cost sharing premiums, daycare

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