Job Information
Firelands Regional Medical Center Financial Navigator, Infusion Center: FT 8a-4:30p in Sandusky, Ohio
Description
Position Highlights:
Work/life: You will find support to help you manage your personal life while building a career.
Lifestyle: Sandusky was voted “Best Coastal Small Town in America”. You will have the opportunity to enjoy living and working in this growing area along the beautiful shores of Lake Erie.
Employee-centric: Tuition reimbursement, loan forgiveness, comprehensive major medical, dental and vision insurance, paid time off, 401(k), health and wellness offerings, monthly employee events, and more.
About Firelands Health:
Our goal at Firelands Health is to be the best & preferred independent healthcare employer for the Sandusky Bay region.
Firelands Health is the area’s largest and most comprehensive resource for quality medical care. We are “big enough to care for you, and small enough to care about you”. We are locally managed and governed as a not-for-profit healthcare facility, serving the counties of Erie, Ottawa, Sandusky, and Huron, covering a regional service area with over 300,000 residents. Our mission is to provide excellent healthcare, promote community wellness, and improve the lives we serve.
Our Core ACE Values: Attitude: We choose to be positive and inclusive every day. Commitment: We are committed to exceed the expectations of those we serve. Enthusiasm: We will work passionately to make a difference.
What You Will Do:
Meets with new treatment patient and reviews any patient access needs and /or barriers to care prior to and throughout treatment.
Monitors daily new patient encounters, verifying insurance coverage, obtaining benefits to determine eligibility, obtains initial and subsequent authorization and pre-certification, and documents accordingly. Assists the clinical team with tracking visits and obtaining re-certification from insurance companies.
Verifies current insurance coverage, including out-of-pocket costs, deductibles, and/or coinsurance and provides cost of care estimates when needed. Assists patients in overcoming financial barriers within the health care system to ensure prompt diagnosis and treatment.
Ensures maximum optimization of patient’s health benefits and coordination of service to facilitate medical necessity throughout the patient’s care continuum.
Facilitates the involvement of community organizations that can help with access to services.
Coordinates all payer co-pay on-line assistance programs and assists patients with applications. Works with financial counseling and charitable organizations to access financial assistance, co pay assistance, prescription assistance, and/or drug replacement as needed.
Acts as the patient’s direct point of contact for all insurance and billing concerns.
Tracks problem encounters and works closely with coding, patient accounting on denials and medical necessity issues to assist in resolution and process improvement.
Assists with coordinating transportation and completed mileage forms for patients as needed. Assesses and completed advanced care planning for cancer patients.
Meets with cancer patients who are experiencing psychosocial distress as indicated by RN assessment or completion of a distress screening. Provides emotional support to patients and assists with outgoing referrals as needed.
Monitors and reports outcome measurements.
Tracks grants and alternative funding.
Assists with chemotherapy and radiation authorizations as needed for coverage in other areas of the infusion center and cancer center.
Conducts ongoing outreach to health disparity communities.
What You Will Need:
Must complete the Association of Community Cancer Center Financial Bootcamp within one year of hire and the Advanced Care Planning Course for cancer center navigators.
Experience with pre-authorization and working with insurance companies preferred. Knowledge of Medicare/CMS terminology and coverage is beneficial. Must have the skills to verify commercial insurance/Medicare and the ability to obtain benefits to determine eligibility.
Tracks problem encounters and works closely with coding, patient accounting on denials and medical necessity issues to assist in resolution and process improvement.
Requires problem solving, decision making, critical thinking, focus, excellent leadership skills, organizational skills, verbal, and written communication skills, and interpersonal skills.
Demonstrates the ability to be self-directed, and to work with and lead teams.
Flexibility in scheduling.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)