Patient Financial Navigator

We are, a freestanding, physician-owned, comprehensive cancer center based in Albuquerque, NM with a satellite clinic in Gallup, New Mexico. We are an Oncology Medical Home, with a focus on early intervention for patient symptoms, resulting in low hospitalization rates. Our Physicians have won Top 10 Docs in the city of Albuquerque multiple times.

As a successful Medical oncology and Radiation oncology practice, we have expanded our medical practice to include Survivorship, Palliative Care, Breast Surgery, Rheumatology, Pulmonary, Urology, and Neurology.

Make a difference in the lives of patients by joining a physician-led, partnership organization with a patient-centered and evidenced-based medicine approach. You will have the tools, resources, and professional freedom you need to deliver outstanding patient care.

POSITION SUMMARY:

The Patient Financial Navigator provides assistance to patients in determination of financial coverage and benefits; identifies patient coverage and payment issues prior to treatment or a change in treatment; identifies alternate sources of payment for co-pays or uninsured patients. The Patient Financial Navigator will also ensure and perform duties that help the organization achieve its mission, vision while demonstrating and adhering to the core values.

ESSENTIAL FUNCTIONS:Reasonable Accommodations Statement:

To perform this job successfully, an individual must be able to perform the essential duties satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s):

• Meets with all new patients and existing patients as needed.
• Maintain professional and empathetic communication with patients, families, and other members of the healthcare team.
• Educates new patients to NMOHC, discuss office flow, review NP information explains the need to show ALL insurance cards (RX and Medical) to the Front Desk at each visit, answer questions or direct to personnel/resources if necessary.
• Patient counseling- sets up payment plans with patients/families, explains insurance benefits, estimates treatment costs reviewed with patient/families, explains out-of-pocket responsibility, discusses the expectations for payment, offers credit card payments and automatic debits, collects co-payments, deductibles, co-insurance as indicated.
• Assists with processing payments, coordinating with collections, and identifies any billing errors.
• · Identifies patients with no insurance, no secondary insurance, poor insurance, high co-pay or co-insurance, and/or reduced coverage benefit to help find solutions in order minimize out of pocket costs
• Assists patient when there is a site of service restrictions (Hospital/Labs/Drugs-PBM Programs), prior authorization requirements, which services require prior-authorization, coverage issues particular to the patient’s specific treatment plan, and medical necessity issues.
• Develops a plan for patients who are underinsured/uninsured.
• Paperwork navigation- guide patients through the complex paperwork required for any applications, benefits, and payments.
• Attends Patient Education Programs as requested by Management.
• Determines patient coverage benefits, deductible, co-pays/co-insurance, benefit limits.
• Identifies patients with special coverage issues.
• Answers patient questions as it relates to Cobra, Health Savings Accounts, Medicaid, and Medicare.
• Interviews patients to assess their financial needs and help them complete applications for NMCC foundation, all state, federal, and any other assistance programs
• Researches co-pay relief/assistance programs for help with co-pays and stay familiar with different pharmaceutical patient assist programs.
• Document all patient interactions and develop a system of monitoring and following up of all patients.

SKILLS & ABILITIES:

Education and Experience:

• High School Graduate or General Education Degree (GED) from an accredited institution
• 1-3 years related experience (prior authorization, billing, coding, medical administrative, and/or certifications). Schooling in lieu of related experience is also accepted.
• Knowledge of CPT/HCPCS, and ICD-10 codes.
• Ability to understand the variance Explanation of Benefits (EOB’s) received.
• Ability to understand all the billing specialties involved (Chemo, RO, Rheumatology, Radiology, etc.)

Computer Skills:

Intermediate computer skills (Word and Excel), Electronic Medical Records (EMR) & Centricity.

Compensation/Benefits:

• Competitive Salary D.O.E.
• Generous Benefits Package

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person