Enrollment Financial Navigator (Cooper Green)

GENERAL SUMMARY

In this patient advocacy role you will perform a variety of functions in a health care setting by assessing patient needs while they are hospitalized and evaluating their eligibility for health care services once discharged, collecting and recording patient information, and providing information and services to patients, provide education on Cooper Green Mercy Health Services Authority’s program and will assist in the application process. Contact the hospitalized patient or their responsible party to obtain missing or incomplete demographic or insurance information. Verifies insurance through electronic processes; Contacts insurance company to obtain eligibility and verification of covered and non-covered services for scheduled appointments. Enrollment Financial Navigator must be able to multi-task, utilizing and matching a variety of traditional and online access solutions. The Financial Navigator must have a general idea and knowledge about the field. Excellent grammar skills, proofreading, and proficiency in writing along with interpersonal customer service skills.

KEY RESPONSIBILITIES

o   Understand how financial toxicity can impact a patient’s wellness.

o   Meet the patient and/or caregiver of the patient while the patient is hospitalized (or other patient populations as assigned) with the goal of ensuring enrollment as a Cooper Green patient and providing the patient with a follow up appointment post discharge.

o   Work on-site at designated hospital to evaluate a patient’s eligibility and/or enroll for health care services once discharged or while in house

o   Act as a liaison for entities that partner with Cooper Green Mercy Health Services Authority and other departments within the organization/facility, organizing and coordinating meetings either in person, on site and through virtual platforms to communicate status changes and updates related to patient eligibility within the program.

o   Relays program and eligibility criteria to the patient.

o   Communicates and collaborates with patients, physicians, and payors providing them with the necessary information and supporting financial documents.

o   Promotes a culture of safety for patients through proper identification, reporting, and documentation.

o   Ensures accurate and efficient processing of applicants applying for Indigent assistance.

o   HIPAA compliant to ensure confidentiality and integrity for the patient's privacy.

o   Customer service oriented when assisting patients and maintains a calm, reassuring demeanor with patients or family members who may be upset over concerns about charging or amount owed on a bill.

o   Work with patient and care givers to reduce / prevent financial toxicity by guiding patients through the complex healthcare system.

o   Assist patients in gaining access to care by reducing financial barrier.

o   Understand key programs, including but not limited to:  Cooper Green Mercy Health Services Authority, Disability, Social Security, Medicare, Medicaid, and The Marketplace, and/or Commercial Payors.

o   Ensure the patient has all of the information to make the right choice to leverage available programs and services.

o   Understand insurance payor benefits information.

Daily Operations

o   Daily review of patient lists for possible patients that need financial assistance, seeks those patients out by visiting in patient units, emergency departments, telephone, patient interviews or other means.

o   Meet the patient at their hospital bedside to discuss and enroll patient to Cooper Green’s program.

o   Gather patient financial information to determine eligibility.

o   Evaluate the patient’s financial status compared to the federal poverty guidelines and recommend products accordingly.

o   Assists in the referral process to federal and state sponsored payors (Medicare and Medicaid).

o   Assists in the completion of the Cooper Green MHS application and collection of documents.

o   Records in the EMR (NextGen) system of the level of coverage and eligibility information.

o   Ensure all insurance demographic and eligibility information is obtained and entered in the system thoroughly and accurately.

o   Correctly expires inactive payor plans; adds or uses replace function to enter new insurance.

o   Verifies insurance(s) using Real-Time applications, payor websites, or by phone call to the insurance company.

o   Enters insurance information correctly in demographics, selecting appropriate financial classes or plans; records eligibility, effective/expiration dates, co-payments, PCP, and other specified information.

o   Explain financial requirements to patients or other responsible party.

o   Schedule patients for their hospital follow up appointment with their newly assigned PCP or in MOD clinic depending upon PCP availability.

o   Print out appointment reminders along with documents needed for the appointment.

o   Research patient accounts when requested by the supervisor or manager, taking appropriate actions.

o   Maintain appropriate databases, manuals, logs, files, and other required documentation; demonstrate an understanding of patient confidentiality.

o   Assists patients and staff timely and in a clear, helpful manner when performing enrollment assessments and/or verification duties.

o   Proactively shares new information related to enrollment, demographic or insurance updates with all appropriate areas and team members.

o   Other duties and/or other patient populations as assigned by the supervisor.

MINIMUM QUALIFICATIONS

1. Required:

   1. The position requires a high school diploma or equivalent. Dynamic, enthusiastic, and highly customer service-focused personality and ability to consistently deliver an exceptional customer service experience. 

   2. Dedicated to increasing overall customer service satisfaction by displaying excellent communication/telephone skills at all times.

   3. 2+ Years of Customer Service experience is required.

   4. Experience in health information management, physician office, hospital or other clinic environment

   5. Must be detail-oriented with the capability to handle confidentiality.

   6. Must have good communication skills.

   7. Must have computer proficiency with typing skills >35 words per minute.

h.      Access to reliable personal transportation with a valid driver's license and auto insurance required

                                                    i.  Auto insurance must include: $100,000 of bodily injury per person; $300,000 per accident for bodily injury liability; and $100,000 per accident for property damage liability.

1. Preferred: 

   1. Working knowledge of processes for all major insurance carriers, intermediaries, Medicare and Medicaid

   2. Bilingual ability.

WORK ENVIRONMENT

This on-site role will travel to other nearby clinic locations.

May need to lift up to 50 lbs on occasion and 51+lbs with a colleague or team.

May have access to sensitive data

PAY RANGE

$16.50-26.80