PAS Oncology Financial Navigator-CRCR Cert required

Posted:
8/13/2024, 9:25:36 AM

Location(s):
Georgia, United States

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Customer Success & Support

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

CRCR Certification required

This role is full time days:

Shifts are:

Mon/Tues/Thur: 8a-4:30p     Wed: 7:30a-5p         Fri: 7:30a-3:00pm

Virtual interviews are being conducted. Experience required.

Overview
The Oncology Financial Navigator is responsible for assisting patients to access financial resources. Serves as a liaison between NGOC, Infusion Therapy and Radiation Oncology Departments.
Coordinates full patient financial counseling, education & referrals, employs and completes all patient liability collection escalations through proper collection of all estimated patient liabilities, including co-payments and unmet deductibles before, during and after time of service.



Promotes excellent customer service and strong communication skills to assist patients to access financial resources. Submit applications for PAPs and determines eligibility for any Federal, State, or internal healthcare assistance programs. Evaluate patient insurance benefits and counsel patients on financial matters, including benefits, financial support, drug assistance, co-pay assistance and other assistance programs. Handles inquiries from customers regarding any aspect of services received or status of accounts.

Verifies and post transactions. Follows established procedures for processing receipts, cash, etc. Sorts and files various documents. Establishes financial arrangements to reduce financial risk for WHS, helping to ensure that Wellstar is reimbursed for its services.

Has functional knowledge of patient access and billing operations in the specialized field of medical oncology.

Responsibilities
Core Responsibilites and Essential Functions

  • Quality/ Safety
    * Assist appropriate patients to explore options for financial assistance for oncology services.
    * Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information.
    * Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patient’s third party payer.
    * View charges to determine financial estimates and collects appropriate co-pays/ and or deductibles.
    * Makes corrections and updates patient account information in computer.
    * Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
    * Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
    * Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as related to assigned duties. Understands the admission, outpatient and emergency registration process.
    * Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
    * Consistently demonstrates the ability to organize work recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
    * Maintains proficiency in data entry skills.
    * Assists with Medicaid screening on all accounts.
    * Resolve error in Patient Work Queues
    * Follow up with patients for financial assistance needs.
  • Customer Service
    * Greets all guest with a positive and professional attitude.
    * Answers incoming phone calls and follows through with requests made.
    * Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public. Demonstrates ability to tactfully handle difficult situations.
    * Presents a well-groomed and professional image in coordination with dept/ hospital dress codes.
    * Provides appropriate telephone etiquette and scripting.
    * Must be flexible with work hours to meet department needs.
    * Meet’s service recovery and customer service guidelines.
    * Keep current & convey knowledge of various insurance plans to customers as needed.
  • Budget/Financial
    * Attempts to collect the estimated self-pay balance of all inpatient, outpatient, and ER accounts, at the earliest possible collection control point.
    * Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full, prior to discharge, or within ten working days thereafter.
    * Communicates with Medicaid Eligibility team and applicable vendor(s) to determine eligibility and approval/denial status as needed.
    * Completes financial evaluation forms to document guarantors' income, expenses, assets and
    * liabilities.
    * Identifies those patients without adequate insurance coverage. Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid).
    * Maintains a list of health care financial assistance programs and the eligibility requirements for each program. Refers patients/guarantors to sources of outside funding assistance, distributes financial assistance (i.e. Medicaid) applications as need.
    * Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow.
    * Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
    * Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction. Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid.
    * Verifies insurance coverage and benefits.
    * Exceeds monthly quota on a consistent basis. Formally reports results of PAP enrollment activity to direct supervisor, on a daily basis or according to policy. Provides feedback to PAS management concerning PAP enrollment and data integrity issues.
    * Responsible for completion of appropriate error/issues in WorkQueues.
  • General
    * Observes work hours and provides proper notice of absences, tardies work schedule changes.
    * Cross-trained in all areas of registration.
    * Attends select departmental meetings at the request of WHS Management.
    * Completes annual mandatory training as required.
    * Maintain several Login ID’s & expertise in various insurance pre-certification and authorization processes.
    * Performs other duties as assigned.
    PAS Oncology Financial Navigator are Level III team members and as such serve as preceptors and mentors therefore must:
    * Maintain a 98% based on individual QA audit /or as reported by Epic (min. of 10 accounts) registration accuracy rate or higher in the past 12 months.
    * Maintain minimum productivity requirements.
    * Has no corrective disciplinary action during the past twelve (12) months.
    * Willing and able to function as a preceptor in the orientation of new patient access personnel and students.
    * Maintain required certifications by obtaining necessary CEUs and submitting timely to certifying board.
  • Required for All Jobs
  • Performs other duties as assigned
  • Complies with all WellStar Health System policies, standards of work, and code of conduct.

  • Qualifications
    Required Minimum Education
  • High school diploma Required or
  • GED Required and
  • Associate's Degree Preferred
  • Required Minimum Experienc
  • Minimum 1 year healthcare experience in Patient Access Services, Practice Operations, or Patient Financial Services Required and
  • Bachelor’s degree or higher may substitute for experience Required and
  • Epic experience Preferred
  • Required Minimum Skills
  • Effective communication skills (both written and verbal) with the ability to communicate with various members of the healthcare team.
  • High attention to detail, self-directed and a positive attitude are essential.
  • Effective problem solving and critical thinking skills.
  • Typing or data entry competency of at least 40 words/minute.
  • Cash handling and balancing.
  • Demonstrated professionalism, effective communication skills and active listening skills.
  • Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred.
  • Required Minimum License(s) and Certification(s)
  • Cert Healthcare Access Assoc 1.00 Required 1.00

  • Certified Patient Account Rep 1.00 Required 1.00

  • Certified Revenue Cycle Rep 1.00 Required 1.00

  • Additional Licenses and Certifications
     

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.