Patient Financial Counselor/Navigator - Outpatient Oncology

Employment Type: Full time Shift: Day Shift Description: Trinity Health, one of the nation's top health care services providers, spanning five counties in Southeastern Michigan. Trinity Health represents more than 2,700 physicians and 14,000 nurses and staff, and includes 6 Hospitals, 5 Outpatient Health Centers, 8 Urgent Care Facilities and over 25 Specialty Centers. We have an opportunity for a Patient Financial Navigator (Counselor) supporting our Oncology department. This is a full-time benefited position. We seek individuals who can be strong advocates for our outpatient oncology patients. Candidates with Medical Billing, Insurance Verification, Medical Terminology, Experience with Approvals, Denials and strong EMR skills are encouraged to apply. CHONC Certification is preferred but not required. Trinity Health System is one of Michigan's most advanced cancer providers. We use cutting edge treatment technology, provide the latest clinical research trials, offer classes, events and support groups as well as other cancer support services, and our multidisciplinary team approach provides the highest quality patient outcomes which shows in our accreditations and recognitions. POSITION PURPOSE Under limited supervision, assesses financial needs of new and established oncology patients based on specified treatment protocols. Determines liability on patient accounts, works with patients or their representatives to provide financial assistance, and facilitates processing of Medicaid and other financial assistance applications. Provides patient and health care team education and links to resources. Also responsible for data collection, initiating eligibility determination for the Health System’s charity care fund, and resolution of accounts receivables. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution. Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to Trinity Health System. Discusses patient and hospital information only among appropriate personnel in appropriately private places. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management. Behaves in accordance with the Mission, Vision and Values of Saint Joseph Mercy Health System. Provides initial insurance verification/patient registration for upcoming appointments. Verifies and updates patient demographic information on registration and billing systems. Communicates with providers, insurance companies and/or caseworkers, to obtain global referrals for office visits. Counsels patients/families prior to treatment, as well as throughout treatment, on the cost of treatment, insurance benefits, resources for payment and financial assistance prior to treatment. Secures and documents payment arrangements. Discusses local, state and federal assistance programs, as well as charity programs in detail with patients in need, acting as an advocate and educator for them. Follows up with patients in a timely manner. Assists patients in developing a financial plan and assesses for financial disparities, as well as completing applications for financial assistance (i.e., Medicaid/Medicaid Disability, County Health Plans, McAuley Support, etc.). Confirms/Audits treatment plan is coded appropriately in billing system. Provides financial needs assessment to the physicians so as to determine treatment interventions that best fit the patient’s medical and financial needs. Obtains initial and subsequent authorizations for chemo services. Notifies ordering physician’s office and infusion center when patient is ready to be scheduled. Secures other financial assistance, if needed. (i.e., Commercial co-pay assistance, Co-pay Foundations, Pharmaceutical Patient Assistance Programs, etc.) Coordinates with Oncology Pharmacy, Billing, IHA Hematology Oncology, Cancer Care Specialty Center, Infusion Clinics, Radiation Oncology, AIM Clinic, Women’s Health Center and the Mercy Cancer network Financial Navigator Affinity Group. Acts as the liaison with other SJMH service areas, family members, and physicians regarding billing requirements and financial assistance, and coordinates activities to avoid reimbursement delays. Collects co-pays, deductibles and other out of pocket amounts at the time of visit. Updates and maintains patient records and other applicable databases Updates patient Medicaid status monthly. Reviews Infusion schedule weekly for indigent patients. Discharge series patients that have expired. Stays up to date on insurance guidelines and collection laws and rules through self-education and seminars as requested. REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE Education: High school diploma or equivalent and one year of specialized training required. One to two years progressively more responsible related work experience required. Experience with health insurance guidelines, programs and plans; patient and co-pay assistance programs; Medicare and Medicaid health plans: COBRA guidelines, and the ability to find new programs to assist patients preferred. REQUIRED SKILLS AND ABILITIES Knowledge of basic accounting principles and patient billing procedures required. Excellent Customer Service skills required. Strong communication skills to effectively provide education and financial counseling to patients and families related to their payment plans, accounts. Also required when working with insurance companies, providers, and other SJMH and/or Oncology department staff required. Interpersonal skills necessary to work collaboratively with the treatment team required. Analytical skills necessary to calculate patient liability, income status and solve problems related to credit and collection matters required. High level of initiative and able to manage a variety of tasks and problems simultaneously required. Demonstrated knowledge of SJMH patient accounting systems and accounts receivables. Employees of Trinity Health enjoy… Competitive compensation Full benefits package including Medical, Dental, Vision, PTO, Life Insurance and Disability Retirement savings plan with employer contribution Opportunity for growth and advancement throughout SJMHS and Trinity Health Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.