This position will serve as a financial navigator to patients, identifying medical financial needs based on insurance coverage and providing guidance to patient in acquiring sustainable coverage as they maneuver through treatment. Will provide education to patients to ensure understanding and provide support, explain the financial implication of patient care and share available sources of assistance. Will act as the patient’s direct point of contact for all insurance and billing concerns during their treatment.

• Coordinates verification of insurance eligibility, insurance benefits, and prior authorization to determine out of pocket responsibility for patients.

• Meets with the patient and his/her family to review information found for out of pocket costs before treatment starting if possible

• Gather and assess financial data to help determine patient eligibility for Medicaid, SSI, charity and other financial assistance programs while working cohesively with associated vendors (Such as MASH).

• Works as an advocate for the patient to optimize access and qualification for available benefits/assistance.

• Complete insured and uninsured patient estimates upon request.

• Provides patient education if patient is not covered/ or losing a group health plan coverage, will present options of coverage they may be able to purchase.

• Tracks patients that may be transitioning from group health plans to Medicare to insure they understand options of coverage.

• Works in conjunction with the Pharmacy Medication Recovery Coordinator to determine pharmacy programs the patient may be eligible to get assistance.

• Collaborates with the Pharmacy Medication Recovery Coordinator in entering and tracking data in the Pharmacy assistance software.

• Guides/assists patients to apply for programs available to aid with expenses outside the SPH medical bills.

• Collaborates/refers patients to SHIP so patients can optimize external assistance programs.

• Serves as a patient liaison for medical financial matters throughout treatment, including following up on insurance questions with PARS

• Does quarterly reviews as long as the patient is in treatment to determine financial risks to the patient.

• Project a positive and helpful demeanor while working with patients, visitors, and staff.

• Responsible for timely documentation of all pertinent information on the patient account and all other tracking tools.

• Responsible for evaluating, tracking, and logging patient assistance applications and HIPAA release of information forms

• Handle walk-in and incoming customer service questions. Including but not limited to charge explanation, relaying/explaining insurance activity, set up payments arrangements.

• Maintain compliance with state and federal regulations as they relate to Patient Financial Services.

• Reconciles credit card transactions, daily cash drawer reconciliation.

• Functions as a liaison for the department to ensure open and effective communications between Case Managers and Patient Access and any clinical areas patient is getting treatment

• Responds to all Smart Sheet items assigned to them within 2-7 business days

• Constantly seek and maintain knowledge of new/existing avenues of financial assistance and support for patients.