Patient Financial Navigator

Description

POSITION SUMMARY:

The Patient Financial Navigator is responsible for guiding patients on their financial responsibilities related to treatment and assisting them in understanding and managing complex healthcare costs. This role involves frequent communication with patients, payers, third-party vendors, and internal teams to ensure coordinated financial support and patient access to care.

CORE ESSENTIAL RESPONSIBILITIES:

• Collaborates with Revenue Cycle, Pharmacy Services, and Front Desk teams to align on patients’ financial plans.
• Ensure timely processing of medication refill requests and report any issues or late deliveries to management.
• Coordinates access to financial assistance, copay support, and free drug programs for eligible patients.
• Obtains and verifies required signatures for all financial assistance documentation.
• Meets with patients (in person or virtually) to explain out-of-pocket responsibilities prior to treatment.
• Responds promptly to patient and staff related financial assistance inquiries regarding billing, insurance, or treatment financial obligations.
• Communicates with third-party vendors to resolve patient account issues.
• Flags potential insurance coverage issues to Pharmacy Services to avoid delays in care.
• Assists in maintaining proper documentation and workflows related to patient financial support.
• Provides coverage for other financial navigators as needed to ensure uninterrupted support.
• Ensure co-pay cards and grant information are entered into EPIC patient accounts and any financial assistance platforms.

Requirements

REQUIRED EDUCATION & EXPERIENCE:

• High school diploma or equivalent required; associate degree in healthcare administration or related field preferred.
• Minimum of 3 years of experience in medical billing, insurance verification, or patient financial counseling.
• Experience working with EMR systems (e.g., EPIC) and knowledge of insurance benefits, prior authorizations, and financial assistance programs.

REQUIRED CERTIFICATES, LICENSE OR REGISTRATION:

• None

REQUIRED KNOWLEDGE, SKILLS OR ABILITIES:

• Strong understanding of health insurance processes, including benefits verification, coordination of benefits, prior authorizations, and payer guidelines.
• Knowledge of financial assistance programs, copay cards, grant funding, and reimbursement procedures in a healthcare setting.
• Proficiency in using electronic medical record (EMR) systems (e.g., EPIC) and patient accounting software for documentation and financial tracking.