Employment Type:

Full time

Shift:

Day Shift

Description:

SPECIALITY CARE FINANCIAL NAVIGATOR

What you will do:

• Case management of complex financial clearance needs for patients and elevates cases to Specialty Care Coordinator and/or Manager as appropriate.

• Processes requests from billing team or insurance company for letters of medical necessity.

• Monitor assigned patient accounts through entire revenue cycle to ensure copay program claims, payments, denials, and other assistance programs are being processed properly.

• With a high level of initiative, assesses the financial needs of Cancer Center patients, establishes a positive supportive relationship, works collaboratively with the Care Team in developing a plan of care, and thoroughly documents.

• Communicates and collaborates with the treatment team on the financial implications of medical intervention to both the patient and the health care provider. Coordinates with the patient, physician, insurance company, and pharmaceutical company to complete the required pre-authorization process for specified chemotherapy drugs, to include diagnostic and prior therapy requirements according to FDA and NCCN guidelines.

• Responsible for implementing procedures to maximize reimbursement and minimize financial losses as related to authorization requirements for specialty care services, such as oncology, neurology and nephrology. Assesses financial needs of new and established patients according to specified protocol for Cancer Care Centers and other specialty clinics as assigned. 

• Provides services in areas of financial need to patients, families, and the health care team as appropriate.  Explores, recommends, and coordinates the varied financial assistance options available to patients in order to ensure the provision of the best financial resources possible for each patient in assigned specialty clinics, while maximizing revenue for the company.

Requirements:

• Bachelor's degree in Healthcare, Business, or Finance preferred.  5 years of experience working with customer service or financial needs of patients in the medical field may be considered in lieu of degree.

• Minimum of 2 years of experience working in a specialty clinic, hospital, or finance setting required, preferably in oncology.

• Minimum of 1 year of experience in determining insurance medical benefits preferred. Advanced training and/or certification, such as Registered Nurse, Licensed Practical Nurse, Certified Pharmacy Technician, or medical coding preferred.

POSITION HIGHLIGHTS:

• Location: Position is a hybrid.

• Hours are traditional daytime office hours.

• Day 1 Benefits: Colleagues with Saint Alphonsus are eligible for benefits from their very first day of work.

• Team Environment: Collaborate with a dedicated team focused on patient care and quality outcomes.

• Visit www.saintalphonsus.org/careers to learn more about the benefits, culture and career development opportunities available to you at Saint Alphonsus Health System.

When Saint Alphonsus takes care of you, you can take better care of our patients. We foster personal and professional growth and offer opportunities that empower our colleagues to develop their careers. Our belief in work-life balance compliments the natural beauty, diverse landscapes, and outdoor recreation lifestyle that is unique to Idaho and Oregon. 

• We offer market-competitive pay, generous PTO, and multiple options for comprehensive benefits that begin on day one.

• Benefits for your future include retirement planning and matching, college savings plans for your family, and multiple life insurance plans that can change as your needs develop.

• We are proud to offer Employee Assistance Programs, tuition reimbursement, and educational opportunities to help you learn and grow.

Visit https://www.saintalphonsus.org/careers/ to learn more!

ABOUT SAINT ALPHONSUS:

Saint Alphonsus Health System is a faith-based ministry and not-for-profit health system serving Idaho, Oregon, and northern Nevada communities. The health system boasts 4 hospitals, 609 licensed beds, and 73 clinic locations. Through innovative technologies, compassionate staff, and healing environments, Saint Alphonsus' goal i