Specialty Care Financial Navigator

About the role

Responsible 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.

Requirements

• Bachelor'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.
• Minimum of 2 years of experience working in a specialty clinic, hospital, or finance setting required, preferably in oncology.
• Minimum of 1 year of experience in determining insurance medical benefits preferred.
• Advanced training and/or certification, such as Registered Nurse, Licensed Practical Nurse, Certified Pharmacy Technician, or medical coding preferred.

What You Will Do

• Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions.
• Responsible for obtaining pre-authorizations for all oncology related treatment.
• Responsible 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.
• Maximizes the organization’s ability to reduce unnecessary financial losses associated with prior authorizations and utilization of patient assistance programs (to include free drug programs).
• Processes requests from billing team or insurance company for letters of medical necessity.
• Affords assistance in the development and tracking of indicators, thresholds and data collection as assigned.
• Maintains confidentiality in matters relating to patients and families.
• Takes initiative and action to respond, resolve, and follow up with customer service issues for all customers in a timely manner.
• Reports to appropriate personnel regarding assignments and projects.
• Communicates effectively, follows through on assignments, uses resources efficiently, participates in learning opportunities, and treats others with respect and dignity.
• Serves 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.
• Understands and demonstrates behaviors consistent with the mission and values of the organization while contributing to the overall success of the strategic plan.

HIGHLIGHTS AND BENEFITS

• Market-competitive pay.
• Retirement planning and matching.
• Colege savings plans for your family.
• Multiple life insurance plans that can change as your needs develop.
• Employee Assistance Programs.
• Tuition reimbursement.
• Education opportunities.