Patient Financial Navigator

Cape Fear Valley Health; Fayetteville (NC); On-site; USD 36,000 - 48,000; Full time

Job summary

Cape Fear Valley Health in Fayetteville, NC seeks a Patient Access Specialist to support the PFS Financial Clearance area. This clerical role handles preadmission activities, verifies insurance, and collects patient responsibilities at the point of service.

You will interview patients, obtain demographics and financial details, determine required authorizations, and document information in the registration system while complying with HIPAA and hospital policies.

Qualifications

• English reading/writing and communication skills are required.
• Knowledge of insurance and collection of payments is needed.
• Knowledge of Medical Terminology is required.
• Familiarity with Microsoft Office software is expected.
• Strong customer service and problem-solving abilities are essential.
• Ability to manage stress and adapt to patient needs and schedules.
• Employees may rotate shifts and hours to meet department needs.

Responsibilities

• Contacts and interviews patients, responsible parties and insurers regarding hospital services to secure benefits.
• Performs insurance eligibility/benefit verification and documents in the registration system.
• Determines need for pre-certifications and authorizations and contacts payers/physicians as needed.
• Pre-registers patients with demographic, financial, and insurance information.
• Validates medical necessity and ensures authorization matches tests/procedures.
• Contacts physicians for clarification when needed.
• Informs patients of liabilities and collects co-pays and balances at registration.
• Calculates patient liabilities and provides financial counseling and payment arrangements.
• Screens patients for market insurance and follows up on denials; initiates appeals as needed.
• Maintains HIPAA-compliant patient information and assists with documentation.
• Meets accuracy standards and resolves missing documentation; performs other duties as assigned.

Skills

English language proficiency

Insurance knowledge

Medical terminology

Microsoft Office

Customer service

Problem solving

Communication skills

Stress management

Flexibility

Education

High school diploma or equivalent

Associates degree in Business or Health Care Administration

CPAS certification within 1 year

Tools

Microsoft Office

Job description

Cape Fear Valley Health in Fayetteville, NC seeks a Patient Access Specialist to support the PFS Financial Clearance area. This clerical role handles preadmission activities, verifies insurance, and collects patient responsibilities at the point of service.

You will interview patients, obtain demographics and financial details, determine required authorizations, and document information in the registration system while complying with HIPAA and hospital policies.