Overview
To manage and participate with team providing early financial navigation services to patients across the Oncology service line in an effort to minimize financial toxicity. To ensure prior authorizations are completed and to provide financial screening and resources for the oncology patient, family and/or caregiver. To function in the role of financial advocate during the entire cancer treatment continuum. To share financial concerns and interventions with the oncology multidisciplinary team.
Responsibilities
Accomplishes individual and team goals and objectives established by Administrative Director based on Mission Statement and Core Values of the organization - Teaches/directs/advises/informs other members of the financial navigation team in an appropriate manner with regard to financial resources and prior authorizations.
- Collaborates with medical, nursing, and ancillary staff to identify patient or family financial needs.
- Work with members of the financial team to ensure prior authorizations are completed in a timely manner.
- Informs patients, families and caregivers of payment mechanisms, to include financial assistance, insurance coverage, and Medicare/Medicaid benefits. Refers patients to appropriate resources within or outside of FirstHealth.
- Serves as an important link in the communication chain; ensuring authorization and financial information is transmitted between nursing personnel, physicians, social worker, other patient navigators and care team members
Uses appropriate problem-solving approach to plan service - Identify and assess patients newly diagnosed with cancer for financial toxicity; Reviewing insurance coverage details and identifying potential gaps in coverage
- Assess all uninsured and underinsured patients for Medicare or Medicaid eligibility
- Develops and implements an individualized financial plan, based upon the patient's needs.
- Coordinates interventions to meet the economic needs of patients in the oncology setting, to include referral to support services, community agencies, transportation services, and governmental assistance programs
- Coordinate with appropriate clinic (i.e. Gynecologic Oncology, Medical Oncology, Radiation Oncology) to educate patient, family and/or caregiver regarding Medicaid, Medicare (Part A, B, and D) coverage
- Demonstrates commitment to patient advocacy in all interactions with patients, family members, visitors, and other staff
- Provides services with consideration of the psychosocial, functional, cognitive, economic, cultural/spiritual, medical, and age-specific needs of those served
- Serves as a guide and advocate for patients, families, and caregivers throughout the outpatient oncology setting to facilitate timely, coordinated care and maximum utilization of resources appropriate to need
- To assist and ensure payment assistance options, and billing questions are coordinated with Oncology Business Management and/or Patient Accounts Department
- Provides overview of resources and process for Medicare Social Security Disability, short- and long-term disability, and commercial insurance
- Assist patient and coordinates COBRA (Consolidated Omnibus Budget Reconciliation Act) payments with appropriate office or department
- Reviews patient accounts regularly to determine if patients with outstanding accounts may require assistance with financial planning or access to financial assistance programs; follows up as necessary
Uses appropriate safety and infection control measures - Adheres to OSHA guidelines for proper infection control measures
- Understands and follows departmental safety measures
- Corrects situations that pose a threat to patients or staff safety. Reports unsafe conditions in accordance with policy and regulation
Uses equipment/supplies correctly - Document accurately in EPIC.
- Manage Vivor Navigation Software and generate necessary reports to capture payment assistance.
- Ensure appropriate use of Cancer CARE Funds to assist with medically necessary services.
Employment Type: FULL_TIME