Specialty Care Financial Navigator

Job description

Employment Type:

nPart time

nShift:

nDay Shift

nDescription:

nGENERAL SUMMARY AND PURPOSE:

nResponsible for implementing procedures to maximize reimbursement and minimize financial losses as related to authorization requirements for specialty care services, such as oncology, neurology and nephrology. Assesses financial needs of new and established patients according to specified protocol for Cancer Care Centers and other specialty clinics as assigned. Provides services in areas of financial need to patients, families, and the health care team as appropriate. Explores, recommends, and coordinates the varied financial assistance options available to patients in order to ensure the provision of the best financial resources possible for each patient in assigned specialty clinics, while maximizing revenue for the company.

nSKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE :

nBachelor's degree in Healthcare, Business, or Finance preferred. 5 years of experience working with customer service or financial needs of patients in the medical field may be considered in lieu of degree.

nMinimum of 2 years of experience working in a specialty clinic, hospital, or finance setting required, preferably in oncology.

nMinimum of 1 year of experience in determining insurance medical benefits preferred.

nAdvanced training and/or certification, such as Registered Nurse, Licensed Practical Nurse, Certified Pharmacy Technician, or medical coding preferred.

nESSENTIAL FUNCTIONS :

nKnows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions.

nResponsible for obtaining pre-authorizations for all oncology related treatment.

nResponsible for obtaining applications for assistance programs (copay and free drug) available to oncology patients and specialty care patients seen in the hospital for outpatient or inpatient infusions.

nMaximizes the organization's ability to reduce unnecessary financial losses associated with prior authorizations and utilization of patient assistance programs (to include free drug programs).

nResponsible for case management of complex financial clearance needs for patients, and elevates cases to Specialty Care Coordinator and/or Manager as appropriate.

nProcesses requests from billing team or insurance company for letters of medical necessity.

nAssists in the development and tracking of indicators, thresholds and data collection as assigned.

nMonitor assigned patient accounts through entire revenue cycle to ensure copay program claims, payments, denials, and other assistance programs are being processed properly.

nAssists with ordering, tracking, and reporting of all free drugs obtained.

nWith a high level of initiative, assesses the financial needs of Cancer Center patients, establishes a positive supportive relationship, works collaboratively with the Care Team in developing a plan of care, and thoroughly documents the findings, recommendations, and interventions made.

nCommunicates and collaborates with the treatment team on the financial implications of medical intervention to both the patient and the health care provider.

nCoordinates with the patient, physician, insurance company, and pharmaceutical company to complete the required pre-authorization process for specified chemotherapy drugs, to include diagnostic and prior therapy requirements according to FDA and NCCN guidelines.

nInteracts with patients and families with varying developmental and socio-cultural backgrounds to reduce anxiety and conveys and attitude of acceptance, sensitivity, and caring.

nParticipates in activities to enhance professional development, to include proactively attending educational sessions with pharmaceutical companies and other financial advocacy organizations.

nTakes initiative and action to respond, resolve, and follow up with customer service issues for all customers in a timely manner.

nReports to appropriate personnel regarding assignments and projects.

nMaintains confidentiality in matters relating to patients and families.

nWillingly accepts personal responsibility for decisions, actions, attitudes, and behaviors that contribute to the overall effectiveness of the organization. Communicates effectively, follows through on assignments, uses resources efficiently, participates in learning opportunities, and treats others with respect and dignity.

nServes as a role model and performs job responsibilities to the highest standards in every situation. Delivers highest level service that ensures a more complete and personally satisfying experience for every customer.

nUnderstands and demonstrates behaviors consistent with the mission and values of the organization while contributing to the overall success of the strategic plan. All actions are rooted in providing excellent customer service.

nDemonstrated working knowledge of medical terminology, pharmaceuticals, Current Procedural Terminology (CPT) codes, and ICD-10 codes.

nMust be knowledgeable in all areas of revenue cycle, from account creation to denials management and collections.

nAbility to manage a variety of tasks and problems at the same time, including coordinating work so deadlines are met. Multiple assignments often need to be prioritized daily.

nAbility to troubleshoot a variety of problems.

nDisplays a high level of initiative and ability to self-direct to solve financial problems of patients.

nAbility to work collaboratively with the treatment team. Must be able to work in an environment with a high level of activity, distractions, and numerous interruptions.

nKnowledgeable in programs available to assist patients with their financial needs.

nProficient in MS Office applications.

nOur Commitment

nRooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

nOur Commitment to Diversity and Inclusion

nTrinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

nOur dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

nEOE including disability/veteran

Worksite address

boise, ID, 83708, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.