Oncology Financial Navigator

2 weeks ago

Fairfax, United States Inova Health System Full time

The Oncology Financial Navigator counsels patients on financial liability by using available financial counseling tools to achieve maximum reimbursement for patient services. Verifies and enters insurance information and authorization/referral requirements into the appropriate system while contributing to a safe patient care environment.

Job Responsibilities

  • Educates and trains others in financial counseling policies and procedures. Provides services, in the area of financial needs, to patients, families and the healthcare team members when appropriate.
  • Provides patient and healthcare team members education, links to resources and data collection in support of easing the financial hardship on patients and their families seeking Oncology services.
  • Partners with Patient Financial Services for claim submission and allocation of payments to the appropriate account. Takes ownership for the Medication Assistance/ Recovery Program. Completes copay assistance applications and follows processes from beginning to end.
  • Efficiently applies for funds and/or grants and foundation programs to pay for out-of-pocket costs for cancer treatments, medications and other healthcare related items that meet our patients needs. Assists others in using online payer systems to complete insurance verification.
  • Serves as a patient advocate, Liaison and educator to assist patients with understanding the cost of care and navigating the continuum of care. Serves as a Liaison between physicians, clinical teams, patients, pharmacies, research teams and contracted insurance plans.
  • Completes pre-determination process for off-label medications and follows National Comprehensive Cancer Network guidelines.
  • Serves as an expert in insurance verification, eligibility, medical necessity and the attainment of drug authorizations when required by insurance carriers for all medications ordered and administered in the Oncology program.
  • Assists in-house financial services team with admission authorizations for Chemo or Oncology related visits. Works with health insurance providers to determine coverage, benefit limits and financial responsibility while conveying this information to the clinical team, patients and families.
  • Performs other duties as assigned.



Additional Requirements

Experience - Four years of experience in healthcare or public health setting with a combination of the following: patient finance, insurance benefits, financial assistance programs, public health, social services or other community based background.

Education - High School or GED

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