Financial Navigator

Bargaining Unit: EA

Rate of Pay: $30.64/hour DOE

Summary

The Financial Navigator serves as a trusted resource for patients throughout their healthcare financial journey. This role helps patients understand the cost of care, insurance benefits, and financial responsibility by providing estimates, explaining coverage and out-of-pocket expenses, discussing payment options, and screening patients for financial assistance resources when appropriate. The Financial Navigator serves as the primary point of contact for financial, billing, and insurance-related inquiries, working collaboratively with patients, providers, insurance companies, and internal departments to promote an exceptional customer experience and support informed healthcare decisions. The position combines customer service, financial advocacy, and revenue cycle expertise to help patients access care with confidence and clarity.

Essential Duties And Responsibilities

• Serves as the primary point of contact for patient financial, billing, insurance, and pricing inquiries.
• Creates and communicates patient financial estimates for scheduled services and prospective patients within the district.
• Verify insurance eligibility, benefits, and patient responsibility.
• Educate patients regarding insurance coverage, deductibles, copayments, coinsurance, out-of pocket expenses, and factors that may affect their final balance.
• Guide patients through the financial aspects of their healthcare journey, helping them understand available resources and make informed decisions regarding their care.
• Conduct inbound and outbound calls related to account balances, estimates, payment arrangements, screening for financial assistance and account resolution.
• Identify and proactively contact patients who may benefit from Financial Navigation services.
• Assist patients in understanding insurance requirements, prior authorizations, coverage restrictions, and other factors that may impact financial responsibility.
• Serve as a resource to staff regarding patient financial responsibility, estimates, payment plans, and financial assistance.
• Research and resolve patient account concerns through collaboration with internal and external stakeholders.
• Document all patient interactions within the Electronic Health Record (EHR).
• Collect and accurately post patient payments.
• Establish payment plans and prepare related patient communications.
• Screen patients for financial assistance programs and coordinate referrals to Financial Counseling as appropriate.
• Respond to inquiries received by phone, MyChart, email correspondence, and in-person visits.
• Utilize interpreter services as needed to ensure effective communication.
• Support front desk operations and assist walk-in patients with questions.
• Utilize EHR and call management systems effectively.
• Assist with staff training and onboarding activities.
• Participate in initiatives that improve patient awareness and utilization of Financial Navigation services.
• Review estimate variances and identify opportunities to improve estimate accuracy, patient communication, and workflow efficiency.
• Maintain required certifications and continuing education.
• Adhere to all organizational policies, regulatory requirements, and customer service standards.
• Demonstrate organizational values and perform other duties as assigned.
  
  

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Supervisory Responsibilities

No supervisory responsibilities.

Minimum Education/Experience

No educational requirement and 6 months to 1 year relevant experience

Required Licenses/Certifications

Healthcare Financial Management Association (HFMA): Certified Revenue Cycle Representative (CRCR)

• Within 1 year of hire into job
  
  

Other Experience/Qualifications

Required:

• Strong aptitude with Microsoft Access
  
  

Preferred:

• Bilingual (Spanish)
• One to two years’ experience working with public and experience in patient registration and/or hospital patient accounting office