Lead Patient Financial Navigator - Hybrid

Cooper University Hospital•Camden, NJ

11h•Hybrid

About The Position

The Lead Patient Financial Navigation Advisor acts as the patient’s liaison from physician order through complete billing cycle. The Lead PFNA will complete a comprehensive analysis of patient’s health insurance to include verification of benefits, prior authorization status and patient’s out of pocket liability. Lead PFNA will educate and provide patient with a clearly defined estimate of the patient’s financial responsibility for all services, including office visits, testing, diagnostic studies, surgeries and procedures via phone, written correspondence and MyChart communication. Lead PFNA will collect or provide payment arrangements in accordance with policies and procedures. In additional to the above, the Lead PFNA will have the following responsibilities: Serve as primary support to the team for insurance and contract questions. Identify and troubleshoot process issues/work with IT to resolve. Liaison with the Managed Care Team to confirm contract accuracy in estimates. Oversee loop line voicemail. Train existing FTEs on new processes. Coordinate training of new hires with Sr. Financial Navigation & Training Analyst. Collaborate with Manager and Sr. Financial Navigation & Training Analyst on special projects. Perform research in future areas of estimate opportunity. Assist with QA of PFNA accounts worked. Deposit reconciliation. Coordination and completion of non-par processes. Financial screening process encompasses any or all of the following job functions: Financially screens insured patients prior to inpatient and outpatient services including office visits, testing, diagnostic studies, surgeries and procedures by verifying patient insurance eligibility and registering insurance information into the EPIC system when needed. Reviews patient history involving past illnesses, treatment locations, diagnosis and final outcomes when CPT codes are not available. Determines outstanding patient responsibility for hospital and physician charges to include past due liabilities in all communication to the patient. Creates financial estimate by providing insurance based out-of-pocket liability estimates for patients scheduled for outpatient and inpatient elective procedures. Establishes contact with the patient. Educates patient on out-of-pocket financial responsibilities including copay, deductible, coinsurance and out-of-pocket maximums. Attempts to collect payment in full prior to date of service or documents in EPIC patient will pay at time of service for Patient Services Representative to collect during registration process. Makes payment arrangements where applicable. Serves as Lead PFNA throughout billing cycle. Monitors Work Queue accountabilities for estimates that need to be completed to balance the patient’s needs, individual performance goals and avoid delays in communication of patient financial liabilities. Provides clear and concise documentation in Epic to ensure precise throughput of patient financial liability information. Uses professional, clear, concise, and customer-friendly communication at all times to internal customers, providers and patients. Provides a stellar experience to Cooper patients; is proactive in serving patients and acts responsibly in the patient and Cooper’s best interest. Resolves patient challenges by offering alternatives with minimum escalation or support, trying to retain patients within the Cooper network. Performs all process and system-related functions in accordance with training and quality guidelines. Perform all related duties or special projects as assigned/required. Regular, consistent and punctual attendance required, following Cooper time and attendance policies. Must display a genuine interest in providing an excellent Customer Experience that aligns with Cooper’s business goals related to patient access throughout the Cooper landscape.

Requirements

Minimum 3 years of experience in healthcare revenue cycle registration, health insurance, patient financial responsibility and point of service collections, working specifically with health insurance plans.
Proficiency in working with payer on-line portals, as well as NaviNet, Passport or other third party eligibility systems required.
Advanced knowledge of Medical Terminology, Health Insurance Plans and Patient Out-of-Pocket financial responsibility.
Experience with EPIC system required.
Proven ability to effectively interact with and provide service excellence to patients, clinicians, physicians and administrators.
Detail oriented with the ability to multi-task using multiple information systems.
Excellent time management, organizational and oral/written communication skills.
Proficiency in use of MS Office Word and Excel.
Demonstrate skills in customer service, with ability to project Cooper values to patients, internal customers and providers.

Nice To Haves

Associates degree or equivalent experience preferred.

Responsibilities

Serve as primary support to the team for insurance and contract questions
Identify and troubleshoot process issues/work with IT to resolve
Liaison with the Managed Care Team to confirm contract accuracy in estimates
Oversee loop line voicemail
Train existing FTEs on new processes
Coordinate training of new hires with Sr. Financial Navigation & Training Analyst
Collaborate with Manager and Sr. Financial Navigation & Training Analyst on special projects
Perform research in future areas of estimate opportunity
Assist with QA of PFNA accounts worked
Deposit reconciliation
Coordination and completion of non-par processes
Financially screens insured patients prior to inpatient and outpatient services including office visits, testing, diagnostic studies, surgeries and procedures by verifying patient insurance eligibility and registering insurance information into the EPIC system when needed.
Reviews patient history involving past illnesses, treatment locations, diagnosis and final outcomes when CPT codes are not available.
Determines outstanding patient responsibility for hospital and physician charges to include past due liabilities in all communication to the patient.
Creates financial estimate by providing insurance based out-of-pocket liability estimates for patients scheduled for outpatient and inpatient elective procedures.
Establishes contact with the patient.
Educates patient on out-of-pocket financial responsibilities including copay, deductible, coinsurance and out-of-pocket maximums.
Attempts to collect payment in full prior to date of service or documents in EPIC patient will pay at time of service for Patient Services Representative to collect during registration process.
Makes payment arrangements where applicable.
Serves as Lead PFNA throughout billing cycle.
Monitors Work Queue accountabilities for estimates that need to be completed to balance the patient’s needs, individual performance goals and avoid delays in communication of patient financial liabilities.
Provides clear and concise documentation in Epic to ensure precise throughput of patient financial liability information.
Uses professional, clear, concise, and customer-friendly communication at all times to internal customers, providers and patients.
Provides a stellar experience to Cooper patients; is proactive in serving patients and acts responsibly in the patient and Cooper’s best interest.
Resolves patient challenges by offering alternatives with minimum escalation or support, trying to retain patients within the Cooper network.
Performs all process and system-related functions in accordance with training and quality guidelines.
Perform all related duties or special projects as assigned/required.
Regular, consistent and punctual attendance required, following Cooper time and attendance policies.
Must display a genuine interest in providing an excellent Customer Experience that aligns with Cooper’s business goals related to patient access throughout the Cooper landscape.