Patient Financial Navigator

📋 Description

• Engage in financial discussions with patients regarding their insurance benefits, coverage decisions, and estimates for out-of-pocket expenses.

• Clarify Kandu's income-based cash-pay program structure and assist patients in qualifying for and enrolling in the appropriate tier.

• Handle incoming calls from patients seeking information about their insurance benefits, billing statements, and available payment options.

• Deliver clear and precise information about coverage for Kandu devices across Medicare, Medicaid, and various commercial insurance plans.

• Assist patients with inquiries related to insurance claims and billing statements, emphasizing single-call resolution.

• Interpret explanation of benefits (EOB) documents and relay findings to patients in easily understandable terms.

• Utilize billing software to review patient accounts, payment histories, and outstanding balances.

• Record all patient interactions and financial counseling sessions in the company’s systems.

• Capable of performing insurance eligibility verification via industry-standard systems with accurate interpretation.

• Assess patient eligibility for financial assistance programs according to established guidelines.

• Propose and arrange payment plans for eligible patients within authorized approval limits.

• Refer complex financial assistance cases and exceptions to the appropriate leadership for evaluation and approval.

• Keep updated on available patient assistance resources and community programs.

• Ensure accurate documentation of all patient financial interactions in compliance with HIPAA and company policies.

• Monitor and report key metrics related to patient financial interactions and their outcomes.

• Collaborate with Revenue Cycle and Patient Services teams to address billing issues and enhance the patient experience.

• Stay informed about changes in insurance policies, coverage guidelines, and reimbursement regulations.

⛳️ Requirements

• High school diploma or equivalent is required.

• At least 3 years of experience in medical billing, insurance verification, or patient financial services is needed.

• Familiarity with Medicare, Medicaid, and commercial insurance benefit structures is essential.

• Proven proficiency with insurance eligibility verification systems and medical billing software.

• Strong understanding of durable medical equipment (DME) billing practices and reimbursement processes.

• Exceptional verbal and written communication skills with the ability to convey complex financial information clearly.

• Demonstrated capability to manage sensitive patient matters with empathy and professionalism.

• Excellent attention to detail and strong organizational skills.

• Proficient in Microsoft Office Suite.

• Preferred: Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field.

• Preferred: Certification as a Certified Patient Account Representative (CPAR) or a similar healthcare financial credential.

• Preferred: Previous experience in a startup or fast-paced healthcare setting.

• Preferred: Familiarity with neurological or rehabilitation medical devices.

• Preferred: Bilingual capabilities (Spanish preferred).

🏝️ Benefits

• Insurance (Medical/Dental/Vision)

• 401(k) with company match

• Unlimited PTO & Holidays

• Life Insurance, Long-Term Disability (LTD), and Short-Term Disability (STD)