Oncology Financial Navigator

POSITION PURPOSE:
The role of the Oncology Financial Navigator is to improve and maximize the revenue capture at SCC/VHH by educating and enrolling oncology patients into Third Party Assistance programs that reduce patients’ out-of-pocket expenses while maximizing savings for VHH’s charity program and reducing the number of patients that fall into collections. The Financial Navigator will assist all SCC patients in navigating available financial resources to help pay for their prescribed therapy and avoid any associated financial toxicity due to their cost of care. The Navigator will research and enroll eligible patients into financial assistance programs from all available internal and external resources, including but not limited to: the VHH Financial Assistance Program, copay assistance programs for IV and oral drugs, drug replacement programs, grants from national oncology foundations, as well as local and community.

ESSENTIAL JOB FUNCTIONS:
Maintain extensive database for Third Party Assistance (TPA) Programs for oncology patient financial assistance and continuously monitor for changes and/or updates regarding each TPA’s available funding and their eligibility and enrollment requirements.
Meet with new patients and their caregivers to provide patient-specific education on their insurance benefits and estimated out-of-pocket expenses for their prescribed therapy prior to treatment initiation.
Help patients complete applications for financial assistance, pharmaceutical assistance, and government programs in a timely and HIPAA compliant manner. Work closely with the Oncology Social Worker on cross over patients and make referrals as necessary.
Track all TPA funding received and report the information to the VP Oncology on a bi-monthly basis. Report trending and forecasting on special projects as requested by VP Oncology.
Obtain all required insurance prior authorizations for oral chemo and therapeutic medications prescribed by SCC provider’s; liaise with specialty and local pharmacies as well as pharmaceutical companies to coordinate medication delivery and provide continuous status updates to patients regarding their prescription drugs. ​​​​​
Serve as the oncology point of contact for all patient billing questions and concerns; work directly with the Patient Financial Services (PFS) staff to resolve all SCC patient billing matters.
Submit patient claims and applications for financial assistance in a timely and HIPAA compliant manner. Post all monies received to the financial system and provide updates to patients as funding is received on their behalf.
Liaise with pharmaceutical company representatives for both IV and oral therapies to learn about their products, co-pay programs and potential foundation assistance. Act as the first line of contact for pharmaceutical reps and communicate applicable changes/updates to the clinical team as appropriate.
Serve as an integral member of the SCC front office team who provides coverage and assistance as needed for planned and unplanned PTO/sick leave for the following positions: front desk/patient access, insurance verification, and medical records. Provide PTO coverage for the oncology business analyst as needed and performs other duties as assigned.
Regularly attend weekly Chartrounds meetings with clinical staff and communicate all pertinent patient information regarding new treatment starts, treatment plan changes, and any urgent patient needs to the appropriate front office staff.
Promote an atmosphere of warmth, compassion, and understanding while demonstrating empathy and the ability to relate to patients and their families. Seek first to understand and come from a place of “What if?”
Role models the principals of a Just Culture and Organizational Values.
Perform other duties as assigned. Must by HIPAA compliant.
This description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

MINIMUM QUALIFICATIONS:

Experience:
3-5 years of experience in a healthcare setting required.
Previous oncology-specific financial navigation or financial counseling experience preferred.
Experience working in an oncology setting preferred.
License(s):
n/a
Certification(s):
n/a
Computer / Typing:
Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Must be comfortable working with various computer programs, including the MicroSoft Office suite.
Must have working knowledge of the English language, including reading, writing, and speaking English.

Education:
Bachelor’s Degree in healthcare or related field.