Patient Access Navigator

JOB SUMMARY:

The Patient Access Navigator is responsible for providing financial and insurance counseling to patients and their families by serving as an educator and advocate, assisting patients in understanding their insurance benefits, identifying insurance and financial barriers and locating resources for financial assistance.

JOB RESPONSIBILITIES:

· Perform comprehensive intake assessments of all new patients with complex insurance issues, identifying barriers to care and addressing the needs of each patient in relation to their bleeding disorder care to reduce health disparities.

· Provide culturally competent care and identify knowledge gaps. Provide individualized education to meet the learning needs of each patient and family.

· Communicate care/treatment/insurance coverage concerns to referring Hemophilia Treatment Centers and assist with coordination of additional patient access services as identified.

· Demonstrate empathy and understanding to establish a rapport with patients, family and caregivers.

· Counsel patients and families on cost of treatment, insurance benefits, resources for payment and financial assistance programs.

· Assist patients and families in locating and applying for financial assistance programs to help with treatment costs, including pharmaceutical patient assistance programs, copay foundations and Cascade’s financial assistance program.

· Discuss state and federal assistance programs in detail with patients in need, acts as an educator and advocate. Includes Medicare, Medicaid and Children’s Special Health Care Services

· Determine liability on patient accounts, work with patients or their representatives to provide financial assistance and facilitate processing of Medicaid and other financial assistance applications.

· Investigate and make recommendations on complex cases to help secure funding sources including no-fault/auto, worker’s comp, COBRA, and marketplace plans.

· Coordinate with internal and external teams to avoid delays in treatment due to financial barriers to care.

· Other duties as assigned.

ORGANIZATIONAL EXPECTATIONS:

· Fosters a positive, professional, service-oriented work environment for staff, patients, and colleagues by supporting the Cascade mission and core values.

· Maintains knowledge of and comply with Cascade standards, policies and procedures and code of conduct.

· Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities

· Embraces new ideas and respect cultural differences.

· Complies with all State and Federal regulations and laws and accreditation organization standards, scope of state licensure, and the standards of professional ethics and practice, including employee health and safety protections mandated by the Occupational Safety and Health Administration (OSHA), patient privacy and data security required by the Health Insurance Portability and Accountability Act (HIPAA), and infection control standards of practice.

MINIMUM QUALIFICATIONS:

EDUCATION

Bachelor’s degree in social work, healthcare administration, nursing, or related field required.

EXPERIENCE

Minimum of five years of healthcare experience with preferred experience working with pediatric and/or adult patients with complex medical needs (rare disease, hematology, oncology).

Knowledge of major health plans including commercial, Medicare, and Medicaid is required.

Expertise in medical and pharmacy benefits is preferred.

TECHNICAL SKILLS

Knowledge of medical terminology is required.

Excellent written and verbal customer service skills.

• Basic computer skills, including Microsoft Office Suite.
• Must possess strong leadership and decision-making abilities.

PHYSICAL/ENVIRONMENTAL REQUIREMENTS:

• Ability to lift and carry items weighing up to 40 lbs.
• Frequent standing, walking, bending, reaching.
• Ability to sit or stand for prolonged periods.
• Required to use their hands to operate office equipment.
• Close, distance, and peripheral vision abilities required.

Pay: $60,000.00 - $80,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person