The Oncology Financial Navigator is the key person responsible for the following: Initiation and coordination of pre-certification and prior authorization for patients with their insurance carrier; insurance and eligibility verifications and assessment of financial requirements of recommended cancer treatment; providing financial counseling to patients regarding insurance benefits, co-payments, and maximum out-of-pocket amount pertaining to cancer treatment; researching and securing drug replacement programs for chemotherapy/immunotherapy medications for eligible patients; determining patient eligibility for any Federal, State, and Pharmaceutical assistance programs; validation and coding of radiation charge entry daily; and working closely with the business office to ensure timely claim and account follow-up for Cancer Center patient accounts. The Oncology Financial Navigator is in constant communication with patients, providers, nursing staff, radiation staff, and third-party payers. The Oncology Financial Navigator must also have a functional knowledge of patient access and billing operations in the field of oncology and hematology.

 

Education, Work Experience and Licensure:

  Associates Degree in Medical Coding or related field required. Related work experience with Coding, billing and insurance precertification may qualify in lieu of education.  Bachelor’s degree preferred Project Management Experience preferred Knowledge of diagnostic ICD-10 procedural (CPT) coding and cancer terminology Basic Microsoft Office computer skills including word processing and Outlook Or other experience as deemed appropriate by Director