PFS - Patient Financial Services Navigator FT

GIBSON AREA HOSPITAL•Gibson City, IL

4d•$21 - $26•Onsite

About The Position

The Patient Financial Services Navigator is a professional who serves as a resource for patients by helping navigate and understand the Medicaid process, ensuring accurate insurance information, and supporting timely reimbursement while providing compassionate and professional service. This position helps patients understand their benefits, obtain or maintain Medicaid coverage and complete required paperwork. The Navigator works closely with patients, state agencies, and internal departments to reduce delays in coverage and payment. Overall, the role combines healthcare customer service, insurance expertise, and patient advocacy to help individuals obtain coverage and reduce financial barriers to receiving care.

Requirements

High School Diploma, GED, or Equivalent.
Minimum of 2 years of experience in medical billing, insurance follow-up or related medical field
Familiar with the Legal and Ethical Compliance in charging and billing.
Experience with electronic medical records (EMR/EHR) and billing software.
Excellent written communication skills.
Knowledge of Medicaid eligibility rules and healthcare insurance.
Customer service and communication skills.
Attention to detail and organizational ability.
Problem-solving and advocacy skills.
Familiarity with medical terminology, billing, and EHR systems.
Ability to handle sensitive financial and personal information confidentially.
Ability to explain complex information in an easy-to-understand manner
Ability to work independently and as part of a team

Nice To Haves

Revenue Cycle Knowledge: Understanding of the Revenue Cycle process including claims, payment posting, accounts receivable, denial management, and reimbursement processes.
Technology Proficiency: Experience with practice management systems, EHR/EMR platforms, clearinghouses, and software such as Microsoft Office/Excel.

Responsibilities

Screen patients for Medicaid eligibility and other financial assistance programs.
Verify Medicaid eligibility and update insurance information in the billing system.
Assist and/or Educate patients with Medicaid applications, benefits, covered services, renewals and eligibility questions.
Explain insurance benefits, coverage, copays, and patient financial responsibility.
Help patients complete and submit required forms and supporting documentation.
Follow up with patients regarding missing information needed for Medicaid processing.
Track application status and resolve issues with state Medicaid agencies.
Assist uninsured or underinsured patients with charity care or hospital financial assistance applications.
Work with physicians, nurses, case managers, social workers, and billing departments to coordinate coverage.
Document patient interactions and maintain accurate records in the electronic health record (EHR).
Work with state Medicaid agencies and managed care organizations to resolve eligibility or coverage issues.
Maintain patient confidentiality and comply with HIPAA regulations.
Perform other duties as assigned.