Patient Account Navigator – Chemotherapy & Infusion

Job Description: • Initiates and coordinates insurance or other carrier pre-certification and prior authorization for patients. • Provides financial counseling to patients. • Coordinates with the business office to ensure timely claim and account follow-up. • Completes the pre-certification process communicating with the patient, physician, insurance company, other financial institutions and the hospital. • Interviews patient by telephone or in person to gather financial information in order to determine discounts that may be applicable. • Explains financial responsibilities for services received and payment options to patients and/or insurance or other financial institutes responsible for payment. • Counsels patients regarding insurance benefits and recommends alternative sources of payment and financial assistance when appropriate. • Reviews provider and treatment protocols, determines insurance benefits and patient responsibility, establishes payment arrangements with the patient, and documents appropriate practice management system. • Acts as an advocate for the patient when discussing medical care with the insurance carrier or other financial institute. • Prepares medical necessity letters for the insurance companies and other financial institutes. • Receives and processes information and forms from the patient and insurance company. • Assists patients with obtaining financial resources for oral medication prescriptions by working with pharmaceutical companies and other resources to obtain grants and financial aid for patients in need. • Obtains prior authorizations from insurance to schedule patient scans and specialty clinic referrals. • Performs other duties as assigned. Requirements: • High school diploma or GED required • 12 months experience in pre-certifications, customer service, medical billing, accounts receivable or related experience required • Medical terminology or medical insurance experience preferred • Equivalent combination of education and experience Benefits: • PTO • 401(k) • medical and dental plans • comprehensive benefits package