Financial Navigator - Patient Access @ Cherokee Health Park

Wellstar Health System

2d•Onsite

About The Position

The Oncology Financial Navigator is responsible for assisting patients to access financial resources. Serves as a liaison between NGOC, Infusion Therapy and Radiation Oncology Departments. Coordinates full patient financial counseling, education & referrals, employs and completes all patient liability collection escalations through proper collection of all estimated patient liabilities, including co-payments and unmet deductibles before, during and after time of service. Promotes excellent customer service and strong communication skills to assist patients to access financial resources. Submit applications for PAPs and determines eligibility for any Federal, State, or internal healthcare assistance programs. Evaluate patient insurance benefits and counsel patients on financial matters, including benefits, financial support, drug assistance, co-pay assistance and other assistance programs. Handles inquiries from customers regarding any aspect of services received or status of accounts. Verifies and post transactions. Follows established procedures for processing receipts, cash, etc. Sorts and files various documents. Establishes financial arrangements to reduce financial risk for WHS, helping to ensure that Wellstar is reimbursed for its services. Has functional knowledge of patient access and billing operations in the specialized field of medical oncology.

Requirements

Minimum 1 year healthcare experience in Patient Access Services, Practice Operations, or Patient Financial Services
Epic experience

Nice To Haves

Associate's Degree
Bachelor’s degree or higher may substitute for experience
Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred.

Responsibilities

Assist appropriate patients to explore options for financial assistance for oncology services.
Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information.
Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patient’s third party payer.
View charges to determine financial estimates and collects appropriate co-pays/ and or deductibles.
Makes corrections and updates patient account information in computer.
Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as related to assigned duties.
Understands the admission, outpatient and emergency registration process.
Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
Consistently demonstrates the ability to organize work recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
Maintains proficiency in data entry skills.
Assists with Medicaid screening on all accounts.
Resolve error in Patient Work Queues
Follow up with patients for financial assistance needs.
Greets all guest with a positive and professional attitude.
Answers incoming phone calls and follows through with requests made.
Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public.
Demonstrates ability to tactfully handle difficult situations.
Presents a well-groomed and professional image in coordination with departmental/ hospital dress codes.
Provides appropriate telephone etiquette and scripting.
Must be flexible with work hours to meet department needs.
Meet’s service recovery and customer service guidelines.
Keep current & convey knowledge of various insurance plans to customers as needed.
Attempts to collect the estimated self-pay balance of all inpatient, outpatient, and ER accounts, at the earliest possible collection control point.
Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full, prior to discharge, or within ten working days there after.
Communicates with Medicaid Eligibility team and applicable vendor(s) to determine eligibility and approval/denial status as needed.
Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.
Identifies those patients without adequate insurance coverage.
Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid).
Maintains a list of health care financial assistance programs and the eligibility requirements for each program.
Refers patients/guarantors to sources of outside funding assistance, distributes financial assistance (i.e. Medicaid) applications as need.
Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow.
Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction.
Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid.
Verifies insurance coverage and benefits.
Exceeds monthly quota on a consistent basis.
Formally reports results of PAP enrollment activity to direct supervisor, on a daily basis or according to policy.
Provides feedback to PAS management concerning PAP enrollment and data integrity issues.
Responsible for completion of appropriate error/issues in WorkQueues.
Observes work hours and provides proper notice of absences, tardiness work schedule changes.
Cross-trained in all areas of registration.
Attends select departmental meetings at the request of WHS Management.
Completes annual mandatory training as required.
Maintain several Login ID’s & expertise in various insurance pre-certification and authorization processes.
Performs other duties as assigned.
PAS Oncology Financial Navigator are Level III team members and as such serve as preceptors and mentors therefore must:
Maintain a 98% based on individual QA audit /or as reported by Epic (min. of 10 accounts) registration accuracy rate or higher in the past 12 months.
Maintain minimum productivity requirements.
Has no corrective disciplinary action during the past twelve (12) months.
Willing and able to function as a preceptor in the orientation of new patient access personnel and students.
Maintain required certifications by obtaining necessary CEUs and submitting timely to certifying board.
Performs other duties as assigned
Complies with all WellStar Health System policies, standards of work, and code of conduct.