Financial Navigator

                    

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

                        

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

                                    

Job Title

Financial Navigator

                        

Location

Stuart

                    

Facility

Martin Health North

                     

Department

Finance Administration-Finance

                      

Job Code

001209

                     

Shift

Days

                       

Schedule

8:00am-4:30pm

                       

Job Summary

Meets with patients to review financial responsibility and develops a plan to coordinate resources to supplement patient's out-of-pocket expenses. Promotes an integrated/coordinated approach to managing the continuum of care and financial obligations for the patient and their family members that come to the Institute. Serves as a liaison to patients with internal and external resources for co-pay assistance, drug replacement, and other financial assistance as well as psychosocial assistance.

                         

Job Details

Responsibilities:

• Develops standard operating procedures to guide and build a program that effectively supports the care and financial responsibility of patients.
• Implements new processes to guide patients to the appropriate resources and support services.
• Meets new patients to the Institute, promoting available programs and services.
• Educates patients on availability of Patient Assistance Programs.
• Identifies, evaluates, and resolves cancer patient complaints.
• Assesses eligibility and assists self-pay and under insured patients with Patient Assistance Programs (PAP) for free drug, replacement drug and copay assistance.
• Coordinates with clinical team and social workers in identifying eligible patients as well as obtaining information and documentation for eligible patients.
• Interviews potential patients for assistance and collects all financial forms related to eligible PAP application and maintains data base.
• Monitors and tracks status of application and communicates with pharmacy, physician and clinical team.
• Clarifies patient medications and dosages and generates applications for PAP renewals.
• Forwards adjustment requests to Revenue Cycle Management for assisted patients when applicable.
• Educates staff and Administration to assist in understanding of processes and procedures surrounding PAP's and encourage patient referrals.
• Tracks and monitors data analytics and database related to all new patients being treated at Taussig cancer Center, main campus and region , and their contractual arrangements for cancer services and out of pocket responsibilities.
• Captures data queries that will drive decisions and process improvement for treatment delivery as well as collaboration with payers.
• Obtains authorizations for research and non-FDA approved procedures and treatments; submits letter of Medical necessity and follow-up for approvals on procedures.
• Other duties as assigned.

Education:

• Associate's degree in Finance, Business or other related field.
• Bachelor's degree preferred.
• Additional progressively responsible experience may offset degree requirement.

Certifications:

• None required.

Complexity of Work:

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to take appropriate action in a stressful environment.

Work Experience:

• Minimum three years of related experience in a health care environment or medical office setting with diverse, patient/culture populations, exhibiting problem solving skills.
• Attentions to detail and accuracy.
• Excellent interpersonal skills, process improvement and problem resolution.
• Computer experience and ability to navigate multiple systems simultaneously.
•  Knowledge of insurance coverage, limitations, requirements, eligibility, pharmacy formulary, prior authorization, coordination of benefits, diagnosis codes, billing and collecting.
• Requires strong communication, analytical and critical thinking skills.
• Ability to work with supervision.

Personal Protective Equipment:

• Follows Standard Precautions using perso