Remote Healthcare Financial navigator (USA)

The primary responsibility of the Financial Navigator is to provide financial guidance to patients remotely. The Financial Navigator should exhibit the ability to explain what an “Explanation of Benefits” (EOB) entails and connect it to a financial statement. Additionally, the Financial Navigator should be skilled in communicating the value of the program. This role is pivotal in guiding patients towards healing and relief.
ESSENTIAL FUNCTIONS:
• Sales: Articulate and convey the value of the program to patients.
• Customer Service: Project a positive image that reflects our commitment, compassion, and competence in the treatments offered, while maintaining patient confidentiality.
• Teamwork: Develop and maintain collaborative relationships with staff, demonstrating a willingness and ability to assist others.
• Communication: Present information clearly, concisely, and in a timely manner.
• Problem Solving & Decision Making: Exhibit effective problem identification and resolution skills as a means of sound decision-making.
• Project/Specialized Job Knowledge: Perform duties in a timely manner, identify and participate in special projects, and contribute to the development of standards and competencies related to implementation.
JOB DUTIES:
• Provide exceptional customer service and effective communication.
• Exhibit empathy and multitasking skills.
• Understand high-level medical terminology, as needed.
• Receive and load patient reports from the previous day.
• Research insurance benefits and eligibility through portals, automated lines, and phone calls.
• Explain insurance benefits to patients and how they apply to their treatments.
• Negotiate payment structures and plans for out-of-network (OON) patients.
• Document benefit information and patient phone calls in the Patient Account Information (PAI) and System Files (SF).
• Respond to patient and clinic emails, phone calls, and chat threads regarding patient account questions.
• Log into Working Accounts for efficient account management.
• Research and resolve billing issues.
• Handle customer service escalations.
• Participate in Clinical Receptionist training and assist in the development of training video segments.
• Attend department meetings, training sessions, and other related activities.
• Engage in special projects, which may involve insurance benefit research, guidelines, authorizations for specific patients/plans, changes to rules/practices, and providing feedback and recommendations on protocols and procedures.
• Safeguard patient privacy and confidentiality by following the guidelines set forth in the Privacy and Security Rules of the Health Insurance Portability and Accountability Act (HIPAA).
• Honor the company’s Mission, Vision, and Values.
QUALIFICATIONS:
• High School Diploma, or equivalent required.
• Two years of Medical Sales required.
• Excellent verbal, written, and listening communication skills.
• Competency with a computer keyboard and mouse.
• Pleasant telephone manner.
• Must have stable, reliable, high-speed home internet.
• Excellent communication and customer service skills required.
• Data entry and electronic health records experience preferred.
• Must have a designated separate home office space that is quiet and away from distractions.
REPORTING RELATIONSHIP: Reports directly to the Financial Navigator Manager.
Job Type: Full-Time, Night Shift (12 AM – 9 AM Philippine Time, with 1 hour break), Remote