Financial Navigator - Worcester, MA

UnitedHealth Group

Full-Time
Closes on Friday, May 31, 2024

Job Description

Has an understanding of the care of the cancer patient, including treatment plans. Review patient chemotherapy protocols and determine insurance benefits and patientresponsibility.  Verify eligibility and benefits for all new patients and existing patients receiving treatment. Able to effectively communicate with patients newly diagnosed with cancer who may be emotional, angry, overwhelmed and/or frightened. Has a strong knowledge of healthcare insurance guidelines, programs and plans, patient assistance programs, co-pay assistance programs, Medicare health plans, Medicaid plans, COBRA guidelines and Healthcare reform. Works with patients to help understand and optimize their health insurance and supplemental coverage options for medical and pharmacy benefits. Verifies current insurance coverage, including out-of-pocket costs, deductibles, and/or coinsurance as necessary. Assist patients with insurance questions or denials. Assess patient need for outside assistance with medical care payments and if so, what programs might be available for individual patients, i.e. pharmaceutical, copay assistance, etc. Establish payment arrangements with the patient and document appropriately in thepractice management system co-insurance assistance, etc. Assists patients with enrolling in Medicaid and other government-sponsored healthcare assistance programs. Acts as the patient’s direct primary point of contact for all insurance and billing inquiries. Possess strong research and problem solving skills. Demonstrates a high level of initiative and ability to self-direct to solve financial problems of patients. May need to work collaboratively with the cancer team to adjust care accordingly. Work with billing team on denied, no authorization, no referral claims, and provides feedback and follow up to clinical areas. Discuss payment arrangements with patients for outstanding patient balance. Properly document appropriate information in the Patient EMR. Process additional information requests and coordinate requests for letters of medical necessity from and to insurance companies. Direct day-to-day contact with Providers to assure treatments are approved before administering. Complies with health and safety requirements and with regulatory agencies such as DPH, etc. Complies with established departmental policies, procedures, and objectives. Enhances professional growth and development through educational programs, seminars, etc.  Attends a variety of meetings, conferences, and seminars as required or directed. Performs other similar and related duties as required or directed. Regular, reliable and predicable attendance is required.

Full-Time sympOne_cb1dda065c8ee277d6756e0c16d0bde4 UnitedHealth Group
Financial Navigator - Worcester, MA - 128484