Patient Financial Navigator

CRO Services LLC; Ventura (CA); On-site; USD 52,000 - 72,000; Full time

Job summary

CRO Services LLC in Ventura, CA is seeking a Financial Navigator to manage insurance eligibility and patient financial responsibility in the context of cancer therapies. You will conduct financial counseling meetings, explain costs, verify insurance, collect co-pays, and help establish payment plans in line with policy.

The role emphasizes documentation, coordination with team members, and assisting patients with billing questions, eligibility for charity programs, and access to local grants to

Qualifications

• Two or more years’ experience in medical office setting.
• Experience in collections.
• Requires interpretation of insurance coverage eligibility, and ability to address any in/out of network coverage or self-pay issues.
• Strong knowledge of medical terminology as well as ICD-10 and CPT codes.
• Excellent oral and written communication skills.
• Detail oriented with good organizational skills.
• Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Work under limited supervision with ability to understand and meet department productivity standards.
• Maintains a positive and respectful attitude.
• Bi-lingual in Spanish is a must

Responsibilities

• Meets with patients to explain cost of treatment, insurance coverage, and patient financial responsibility.
• Coordinates proper insurance verification information/documentation of patient’s insurance, to be used to estimate the patient’s financial responsibility.
• Responsible for collecting co-pays/deductibles from patients, assisting with establishing effective and timely payment plans.
• Courteously and professionally works with patients to outline financial obligations related to care, and provides options for patients to meet financial requirements, including assessing financial assistance eligibility, determining insurance coverage eligibility, establishing payment arrangements, collecting preservice payments and co-payments as needed.
• Responsible for monitoring and collecting the financial balances owed by our patients during their course of treatment.
• Reviews all payment /financial options (Financial hardships / Charity, Special arrangement options, Payments plans, etc.) to limit risk of non-payment.
• Assists patients with questions regarding billing and insurance payments.
• Assists patients with applying for local grants, foundations, and free drugs to offset the patient responsibility.
• Complete wrap up meetings with patients at the end of treatment to ensure patients adhere to payment obligations.
• This position serves to educate patients regarding their insurance coverage and individual financial responsibility for cancer therapies. Further, the position will provide patients access to financial resources available to them as well as assistance with the process.
• Completely and accurately document conversations and communication with patients, payors, third party vendors, and any other representative in and outside of the organization.
• Payment postings.

Skills

Bilingual Spanish

Medical terminology

ICD-10/CPT codes

Communication skills

Attention to detail

Mathematical skills

Job description

SUMMARY

The Financial Navigator is responsible for completing all insurance eligibility andverification processes to support individualized financial counseling for eachpatient regarding their financial responsibilities. Financial counselingmeetings will be conducted with all patients within the initial weeks oftreatment. These meetings will result in either payment in full of thepatient’s outstanding balance or the establishment of a payment plan inaccordance with company policy.

Performsthe following duties personally and coordinates with team members to ensuresuccessful completion of assigned tasks.

ESSENTIALDUTIES AND RESPONSIBILITIES

include the following. Otherduties may be assigned.

Essential Duties:

• Meets with patients toexplain cost of treatment, insurance coverage, and patient financialresponsibility.
• Coordinates properinsurance verification information/documentation of patient’s insurance,to be used to estimate the patient’s financial responsibility.
• Responsible forcollecting co-pays/deductibles from patients, assisting with establishingeffective and timely payment plans.
• Courteously andprofessionally works with patients to outline financial obligationsrelated to care, and provides options for patients to meet financialrequirements, including assessing financial assistance eligibility,determining insurance coverage eligibility, establishing paymentarrangements, collecting preservice payments and co-payments as needed.
• Responsiblefor monitoring and collecting the financial balances owed by our patientsduring their course of treatment.
• Reviews all payment /financial options (Financial hardships / Charity, Special arrangementoptions, Payments plans, etc.) to limit risk of non-payment.
• Assistspatients with questions regarding billing and insurance payments.
• Assists patients withapplying for local grants, foundations, and free drugs to offset thepatient responsibility.
• Complete wrap upmeetings with patients at the end of treatment to ensure patients adhereto payment obligations.
• This position servesto educate patients regarding their insurance coverage and individualfinancial responsibility for cancer therapies. Further, the position willprovide patients access to financial resources available to them as wellas assistance with the process.
• Completely andaccurately document conversations and communication with patients, payors,third party vendors, and any other representative in and outside of theorganization.
• Payment postings.

This job description in no way states or implica that these are the only duties to be performed by this employee. He or she will be required to follow any other instructions and to perform any other duties requested by his or her supervisor.

SUPERVISORYRESPONSIBILITIES

Thisjob has no supervisory responsibilities.

QUALIFICATIONS

To perform this job successfully, an individualmust be able to perform each essential duty satisfactorily. The requirementslisted below are representative of the knowledge, skill, and/or abilityrequired. Reasonable accommodations may be made to enable individuals withdisabilities to perform the essential functions.

EDUCATIONand EXPERIENCE

• Twoor more years’ experience in medical office setting.
• Experiencein collections.
• Requiresinterpretation of insurance coverage eligibility, and ability to addressany in/out of network coverage or self-pay issues.
• Strongknowledge of medical terminology as well as ICD-10 and CPT codes.
• Excellentoral and written communication skills.
• Detailoriented with good organizational skills.
• Mathematicalskills: Ability to add, subtract,multiply, and divide in all units of measure, using whole numbers, commonfractions, and decimals.
• Workunder limited supervision with ability to understand and meet departmentproductivity standards.
• Maintaina positive and respectful attitude.
• Bi-lingualin Spanish is a must

Other Requirements

• Travel as required to other centers