Patient Financial Navigator-FT-Day Shift

Start the day excited to make a difference…end the day knowing you did.  Come join our team.

Job Summary:

The Patient Financial Navigator performs all duties associated with the timely, accurate resolution of customer billing issues, questions about all self-pay account balances, and performs follow-up on outstanding balance within the MWHC Patient Financial Navigation department. The incumbent in this position assists patients with payments and billing options, reviews requests for charity care/financial assistance, and serves as a resource to patients/guarantors regarding concerns/questions about charity care and discount policies.

Essential Functions & Responsibilities:

• Completes registrations, maintaining an accuracy rate in accordance with departmental quality goals.
• Ensures the accuracy and completeness of insurance information, verifies eligibility/coverage and ensures authorization requirements have been met. Constructively receives and applies quality assurance feedback.
• Creates and communicates patient estimates to ensure price transparency, provides education regarding insurance reimbursement, self-pay discounts and financial guidelines that may impact patient liability.
• Analyzes data elements within the patient accounting systems to determine the current state of the account and determines the next best action to drive the account towards a resolution status.
• Provides responses to phone calls, internal questions, customer inquiries and correspondence from various departments, outside agencies, payers and patients.
• Guides patients in applying for all eligible programs; communicates with the patient regarding their insurance required co-pay, deductible, authorization, denied charges and patient responsibility.
• Interviews and screens patients against Federal Poverty guidelines (FPL) to determine patient’s eligibility for government funding, local funding or charity care. Guides patients in applying for all eligible programs; communicates with the patient regarding their particular insurance required co-pay, deductible, authorization, denied charges and patient responsibility.
• Sets up payment arrangements within established MWHC guidelines; forwards accounts to designated department for monthly billing; accepts, processes and records payments via phone or in person; documents all interactions in the appropriate patient accounting system. Monitors the online patient payment portal.
• Interviews and screens patients against Federal Poverty guidelines (FPL) to determine patient's eligibility for government funding, local funding or charity care.
• Gathers and evaluates financial information to determine appropriate action, financial assistance, and discount or payment arrangement. Uses authorized form letters when requesting information from patients as applicable.
• Processes applications for charity care/financial assistance and mails approval or denial letters. Applies the charity care and financial discount policy per established guidelines.
• Assures the appropriate write-off approvals are secured based on the MWHC schedule of approval authority and the write-off is processed in the patient accounting systems.
• Initiates patient contact through phone calls, letters, and skip tracing techniques.
• Assesses account documentation including account notes, payment history, account age, and number of contact attempts to make decisions regarding the ability to collect upon the account. Escalates issues and document trends to the supervisor/manager as needed.
• Has a basic understanding of federal and state legal action (warrants, garnishments, real estate liens, and interrogatories). Utilizes and gathers data to determine collection efforts.
• Adheres to Federal regulations, including, but not limited to Health Insurance Portability and Protection Act (HIPAA) and the Fair Debt Collections Practices Act (FDCPA).
• Performs other duties as assigned.

Qualifications:

• High school diploma or equivalent required.
• Minimum of two years Patient Accounts, Patient Access, Collections, or Healthcare customer service experience required.
• Experience with hospital and physician patient guarantor accounts, billing, insurance, and charity care/financial discount policies preferred.
• Certified Revenue Cycle Specialist (CRCS-I) or related industry certification preferred.

As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.