Job Description

Thank you for considering a career at Mercy Health!

Scheduled Weekly Hours:

40

Work Shift:

Days/Afternoons (United States of America)

Reports to Title: Patient Assistance Program Manager

# of Direct Reports0

Primary Function/General Purpose of Position

The Financial Navigator is responsible for comprehensive patient financial management. The Navigator conducts patient financial navigation and patient fiscal need assessments. They will work closely with providers, patients, hospital staff, and practice administration to determine and execute the most appropriate fiscal solutions. The Navigator will provide analytical and operational support for facility administration and financial related activities including drug recovery within facilities, billing and payment processes, and analysis and evaluation of financial performance.

Essential Job Functions

• Conducts financial counseling for all infusion patients prior to initial treatment which includes notification of financial obligations.

• Conducts screening, enrolling, and obtaining copay assistance and/or free drug for patients through Patient Assistance Programs (PAP).

• Manages drug procurement for indigent and underinsured populations and all aspects of drug recovery programs within local facilities; ensures all accounts are submitted for recovery accurately and in a timely manner.

• Monitors drug shipment status from approval through receipt of drug at the hospital pharmacy.

• Develops and maintains a close interface with all components of the drug recovery and copay assistance process including patients, key hospital departments, and drug manufacturers and/or foundations.

• Manages patient payment status and data including insurance coverage, self-pay credits and account write offs to resolve problems determining the cause and expediting correction or adjustment.

• Answers billing and insurance questions as needed.

• Maintains patient assistance database.

• Coordinates procuring free drugs for accounts with medical necessity denials.

• Submits referrals to support services (e.g. Medicaid screening, Bon Secours Mercy Health Charity financial assistance, social worker, marriage and family counselor, etc.)

• Prepares evaluations of hospital, facility, or pharmacy related concerns and proposals to quantify financial implications.

• Compiles and analyzes internal data for inpatient and outpatient services.

• Responsible for distributing various reports to departments as needed.

• Establishes and maintains relationships with other agencies and organizations in community to meet patient needs.

• Coordinates, educates, and trains physicians, clinical staff, and support staff on patient assistance programs (e.g. free drug procurement, copay assistance) and offers in-service training sessions to enhance quality and patient satisfaction.

• Understands and complies with Information Security and Health Insurance Portability and Accountability Act (HIPPA) policies and procedures at all times; uses, protects, and discloses patients’ protected health information (PHI) only in accordance with HIPPA standards.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

Licensing/Certification

Commissioned Notary (required within 6 months of employment)

Education

High School/GED (required)

Bachelors, Business/Healthcare Administration (preferred)

Work Experience

Minimum of 2 years’ experience in a professional healthcare environment (required)

Minimum of 2 years’ experience as a financial biller in a healthcare setting, social worker ,and/or Certified Pharmacy Technician (required)

1 year experience with EPIC functionality (preferred)

2 years’ experience in social work of specialized patient population (e.g. oncology, hepatology, neurology, etc.) (preferred)

Prior experience with patient assistance (preferred)

Training

Completion of Association of Community Cancer Centers (ACCC) Financial Advocacy Boot Camp within 3 months of employment (required)

Skills

Ability to work independently with minimal supervision

Strong computer skills

Knowledge of various software programs (e.g. Microsoft products, Epic)

Ability to build strong relationships within and outside of organization

Proficient math and accounting skills

Ability to manage a variety of complex issues

Critical thinking

Communication

Attention to detail

Finance/Financial Advice

Results-Oriented

Analyzing

Customer Service

Empathy

Interpersonal Skills

Mercy Health is an equal opportunity employer.

As a Mercy Health associate, you’re part of a Misson that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer
• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

Department:

OP Infusion Therapy-LMP - Lourdes

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com