Patient Financial Navigator (Customer Service Focused)

About the role

The Patient Financial Navigator serves as the primary point of contact for patients seeking information about insurance benefits, out-of-pocket costs, and financial assistance options for Kandu medical devices and services. This role requires a detail-oriented professional who can navigate complex insurance landscapes while delivering compassionate, accurate financial guidance to patients and their families.

Responsibilities

• Conduct patient-facing financial discussions regarding insurance benefits, coverage determinations, and out-of-pocket cost estimates
• Explain Kandu's income-based cash-pay program structure and guide patients through tier qualification and enrollment processes
• Field inbound calls from patients with questions about their insurance benefits, billing statements, and payment options
• Provide clear, accurate information about coverage for Kandu devices across Medicare, Medicaid, and commercial insurance plans
• Provide support for patients who have insurance claim and/or statement questions with a focus on single-call resolution
• Interpret explanation of benefits (EOB) documents and communicate findings to patients in accessible language
• Navigate billing software to access patient accounts, payment histories, and outstanding balances
• Document all patient interactions and financial counseling sessions in company systems
• Ability to perform insurance eligibility verification using industry-standard verification systems with correct interpretation
• Evaluate patient eligibility for financial assistance programs within established guidelines
• Offer and set up payment plans for eligible patients within authorized approval limits
• Escalate complex financial assistance cases and exceptions to appropriate leadership for review and approval
• Maintain current knowledge of available patient assistance resources and community programs
• Maintain accurate documentation of all patient financial interactions in compliance with HIPAA and company policies
• Track and report key metrics related to patient financial interactions and outcomes
• Collaborate with Revenue Cycle and Patient Services teams to resolve billing issues and improve patient experience
• Stay current on changes to insurance policies, coverage guidelines, and reimbursement regulations

Qualifications

• High school diploma or equivalent
• Minimum 3 years of experience in medical billing, insurance verification, or patient financial services
• Working knowledge of Medicare, Medicaid, and commercial insurance benefit structures
• Demonstrated proficiency with insurance eligibility verification systems and medical billing software
• Strong understanding of durable medical equipment (DME) billing practices and reimbursement
• Excellent verbal and written communication skills with ability to explain complex financial information clearly
• Proven ability to handle sensitive patient situations with empathy and professionalism
• Strong attention to detail and organizational skills
• Proficiency in Microsoft Office Suite

Preferred Qualifications

• Associate's or Bachelor's degree in Healthcare Administration, Business, or related field
• Certification as Certified Patient Account Representative (CPAR) or similar healthcare financial credential
• Prior experience in a startup or fast-paced healthcare environment
• Experience with neurological or rehabilitation medical devices
• Bilingual capabilities (Spanish preferred)

Pay

$24.50/Hr to $28.00/Hr

Benefits

• Insurance (Medical/Dental/Vision)
• 401(k) with company
• Unlimited PTO & Holidays
• Life Insurance, LTD and STD