Patient Benefit Navigator

Option Care Health•Tallahassee, FL

7d•Onsite

About The Position

Responsible for assisting patients in managing their out of pocket costs, and working with patients who are underinsured and requiring guidance via assistance programs, or pharmaceutical manufacturer programs.

Requirements

High school diploma and 3yrs of relevant experience in the healthcare industry (admissions, verification, intake, billing/collections, or pharmacy.
Excellent communication and negotiation skills along with a caring and compassionate attitude.
Ability to work cooperatively and be a liaison between departments.
Proficient in the use of a personal computer, word processing and electronic spreadsheets.
Basic math skills (addition, subtraction, multiplication)
Working knowledge of medical and prescription insurance coverage.
Understanding of insurance coverage gaps.
Research disease states online.

Nice To Haves

State certification registration or licensure (Certified Pharmacy Technician)
May perform other duties as assigned

Responsibilities

Understand and navigate patient assistance via pharmaceutical manufacturer programs, and foundations for those patients with little or no insurance coverage or those we cannot offer internal assistance by referring them to the manufacturer.
Confirms that patients are enrolled properly in all assistance programs.
Work directly with patients to negotiate copayment arrangements.
Retrieve methods of payment from patient for copay, communicate and notate.
Submits timely and accurate financial analyses and financial assistance options for products and services provided upon receipt of request.
Completes financial assistance review according to established procedures and practices for all requests received for patients receiving specialty therapies on new admissions, therapy changes, or additions to therapy for established patients, for all payer sources.
Understands the terms and fee schedules for all contracts for which patient requests for assistance are submitted.
Generates and mails patient assistance enrollment forms and letters per Option Care policy.
Stay abreast and adhere to Federal, state and contractual requirements regarding copay assistance plans.
Act as a liaison between billing, pharmacy, and nursing to assist in resolving financial assistance related to prescriptions refills.
Update patient information in software system to communicate the outcomes of any agreement.