Financial Navigator NE

Cleveland Clinic•Vero Beach, FL

2d•Onsite

About The Position

Join our team at Cleveland Clinic Indian River Hospital and experience world-class patient care at its best. Located in sunny Florida’s Treasure Coast, Indian River Hospital is committed to providing optimal family- and community-focused services. Here, you will be part of a collaborative, compassionate, and innovative team of caregivers. You will work with state-of-the-art technology and will build a rewarding career with one of the most respected healthcare organizations in the world. As a Financial Navigator, you’ll play a vital role in supporting patients through one of the most challenging parts of their care understanding and managing the financial aspects of treatment. Working closely with individuals undergoing chemotherapy and radiation therapy, you’ll provide clear guidance on costs, coverage, and available resources. In this role, you’ll help patients navigate their financial responsibilities, identify opportunities to reduce out-of-pocket expenses, and connect them with grants and assistance programs. You’ll also meet with patients during treatment to offer ongoing support, ensure documentation is complete, and address questions as they arise. By combining compassion with expertise, you’ll help ease financial stress, empower informed decisions, and make a meaningful difference in patient experience every day.

Requirements

High school Diploma or GED required
Additional progressively responsible experience may offset degree requirement
Attention to detail and accuracy
Interpersonal, process improvement and problem resolution skills
Computer experience and ability to navigate multiple systems simultaneously
Knowledge of insurance coverage, limitations, requirements, eligibility, pharmacy formulary, prior authorization, coordination of benefits, diagnosis codes, billing and collecting
Strong communication, analytical and critical thinking skills

Nice To Haves

Bachelor’s Degree
Microsoft Office skills

Responsibilities

Meet with patients to review financial responsibility and develop a plan to coordinate resources to supplement patients' out-of-pocket expenses.
Promote an integrated/coordinated approach to managing the continuum of care and financial obligations for the patient and their family members that come to the Institute.
Serve as a liaison to patients with internal and external resources for co-pay assistance, drug replacement and other financial assistance as well as psychosocial assistance.
Develop standard operating procedures to guide and build a program that effectively supports the care and financial responsibility of patients.
Implement new processes to guide patients to the appropriate resources and support services.
Educate patients on availability of Patient Assistance Programs.
Identify, evaluate and resolve cancer patient complaints.
Assess eligibility and assist self-paid and under-insured patients with Patient Assistance Programs (PAP) for free drug, replacement drug and copay assistance.
Coordinate with clinical team and social workers in identifying eligible patients as well as obtaining information and documentation for eligible patients.
Interview potential patients for assistance and collect all financial forms related to eligible PAP applications and maintain a database.
Monitor and track status of application and communicate with pharmacy, physician and clinical team.
Clarify patient medications and dosages and generate applications for PAP renewals.
Forward adjustment requests to Revenue Cycle Management for assisted patients when applicable.
Educate staff and Administration to assist in understanding of processes and procedures surrounding PAP's and encourage patient referrals.
Track and monitor data analytics and databases related to all new patients being treated at Taussig Cancer Center, main campus and region and their contractual arrangements for cancer services and out of pocket responsibilities.
Capture data queries that will drive decisions and process improvement for treatment delivery as well as collaboration with payers.
Obtain authorizations for research and non-FDA approved procedures and treatments; submit letter of medical necessity and follow-up for approvals on procedures.