Communicates with utilization management department as necessary to ensure that services are authorized. Reviews and may complete authorizations and referral requests.Includes obtaining and documenting covered and non-covered benefits, plan type, copayments, co-insurance, out of pocket, and deductible amounts and determining contract and benefit eligibility. Directs patients to appropriate departments as needed. Greets customers on the telephone or in person, assesses needs and provides information and /or services requested. Providing excellent customer service to patients, co-workers, and clinical staff. Serve as the PFS Customer Service Representative to the Patient Financial Services Department.Performs self-pay and bad debt collection follow-up as assigned and in accordance with PFS policy. Handles all patient questions and concerns with regard to the processing of patient insurance claims and financial assistance eligibility.Utilizes vouchers in order to perform comprehensive account audits as necessary on self-pay balance disputes, processing of patient refunds, payment transfers and adjustments in accordance with PBO policy. Maintains ability to read and comprehend all payors’ claims adjudication vouchers.Assists patients with Colorado Medicaid application process. Evaluates patient financial applications for Colorado Medicaid eligibility.Interprets individual, self-employed and business financial statements to accurately rate a patient using the guidelines of the charitable programs. Audits and adjusts all charity accounts monthly. Administers hospital financial assistance policies and the Colorado Indigent Care Program (CICP).This includes securing patient payments by negotiating payment plans or arranging alternative settlement agreements. Provides financial counseling by telephone, electronic/standard mail or face-to-face to patients/guarantors to ensure collectability of patient balances and/or accounts in compliance with federal and state laws regarding debt collection and hospital billing and collection policies.Negotiates collection deposits of estimated co-insurance, co-pay and deductible amounts.
#Patient navigator software verification
Evaluates and communicates patient’s potential financial liability directly to the patient prior to medical services being rendered based on insurance verification data and medical cost estimates.Answers a multitude of questions regarding billing, financial impacts, benefits, referrals, authorization, services, estimates, etc., as well as addressing concerns and complaints. Available to meet with patients, scheduled and unscheduled, in the Patient Finance Office.Works with pharmaceutical representatives and companies to establish the correct processes necessary for reimbursement. Assists patients with applying for copay assistance and answers questions as needed. Submits billing to pharmaceutical copay assistance programs for reimbursement of claims.Communicates with management and co-workers when new information/ knowledge on a topic that is beneficial to the team. Identifies training needs for the Patient Finance Office staff and schedules appropriate training sessions. Leads the work of coworkers by providing direction, guidance, training, and resources as appropriate.This includes working with patients and their families to evaluate financial data and determine ability to pay under all payors, negotiating payment arrangements and administering hospital and state financial assistance programs. Evaluates patient’s potential financial liability prior to and after medical services have been rendered. Assists Financial Counseling Supervisor with escalated patient issues and more complicated patient situations as needed. If you believe in Science Transforming Life, we invite you to join our team.Ĭollaborates with management to train and guide new and current employees in the Patient Finance Office. By combining our efforts in comprehensive care, academic education and ground-breaking research, we're able to develop treatments that help our patients live more productive lives. They will collaborate with physicians and staff to ensure an outstanding patient experience.Īs the leading respiratory hospital in the nation, National Jewish Health is pioneering a new era of preventive and personalized medicine. The patient navigator is the first point of contact for our patients, this position represents the face of The National Jewish Health Adult Cystic Fibrosis Center. Our CF center has been recognized nationally and internationally for the work our practitioner and researcher have contributed to this field of medicine. The Adult Cystic Fibrosis (CF) at National Jewish is the largest CF center in the nation.