The Financial Navigator serves as the primary point of contact for patient financial, billing, and insurance inquiries to ensure informed healthcare decisions. They are responsible for verifying insurance eligibility, creating financial estimates, and assisting patients with payment plans and financial assistance resources.
Requirements overview
The role requires 6 months to 1 year of relevant experience and a strong aptitude with Microsoft Access. Candidates must obtain the Certified Revenue Cycle Representative (CRCR) certification within one year of hire.
Proudly serving the community since 1952, Tahoe Forest Hospital is a not for profit rural health care facility and designated Critical Access Hospital. It is fully accredited by the Healthcare Facilities Accreditation Program and licensed by the State of California Department of Health Services. Tahoe Forest Hospital has 25 acute care beds and 36 long-term care beds.
Our geographic area covers six rural counties, two states and approximately 3,500 square miles with primary services reaching the communities of Truckee, North Lake Tahoe, Donner Summit and the Sierra Valley in California and Incline Village in Nevada. Tahoe Forest Hospital serves a full-time population of approximately 40,000 residents with influxes of up to an additional 30,000 tourists during peak periods.
HealthcareFinance & AccountingCustomer Service & SupportAdministrative
Description
Bargaining Unit: EA
Rate of Pay: $30.64/hour + DOE
Summary
The Financial Navigator serves as a trusted resource for patients throughout
their healthcare financial journey. This role helps patients understand the cost
of care, insurance benefits, and financial responsibility by providing
estimates, explaining coverage and out-of-pocket expenses, discussing payment
options, and screening patients for financial assistance resources when
appropriate. The Financial Navigator serves as the primary point of contact for
financial, billing, and insurance-related inquiries, working collaboratively
with patients, providers, insurance companies, and internal departments to
promote an exceptional customer experience and support informed healthcare
decisions. The position combines customer service, financial advocacy, and
revenue cycle expertise to help patients access care with confidence and
clarity.
Essential Duties and Responsibilities
* Serves as the primary point of contact for patient financial, billing,
insurance, and pricing inquiries.
* Creates and communicates patient financial estimates for scheduled services
and prospective patients within the district.
* Verify insurance eligibility, benefits, and patient responsibility.
* Educate patients regarding insurance coverage, deductibles, copayments,
coinsurance, out-of pocket expenses, and factors that may affect their final
balance.
* Guide patients through the financial aspects of their healthcare journey,
helping them understand available resources and make informed decisions
regarding their care.
* Conduct inbound and outbound calls related to account balances, estimates,
payment arrangements, screening for financial assistance and account
resolution.
* Identify and proactively contact patients who may benefit from Financial
Navigation services.
* Assist patients in understanding insurance requirements, prior
authorizations, coverage restrictions, and other factors that may impact
financial responsibility.
* Serve as a resource to staff regarding patient financial responsibility,
estimates, payment plans, and financial assistance.
* Research and resolve patient account concerns through collaboration with
internal and external stakeholders.
* Document all patient interactions within the Electronic Health Record (EHR).
* Collect and accurately post patient payments.
* Establish payment plans and prepare related patient communications.
* Screen patients for financial assistance programs and coordinate referrals to
Financial Counseling as appropriate.
* Respond to inquiries received by phone, MyChart, email correspondence, and
in-person visits.
* Utilize interpreter services as needed to ensure effective communication.
* Support front desk operations and assist walk-in patients with questions.
* Utilize EHR and call management systems effectively.
* Assist with staff training and onboarding activities.
* Participate in initiatives that improve patient awareness and utilization of
Financial Navigation services.
* Review estimate variances and identify opportunities to improve estimate
accuracy, patient communication, and workflow efficiency.
* Maintain required certifications and continuing education.
* Adhere to all organizational policies, regulatory requirements, and customer
service standards.
* Demonstrate organizational values and perform other duties as assigned.
Qualifications
To perform this job successfully, an individual must be able to perform each
essential duty satisfactorily. The requirements listed below are representative
of the knowledge, skill, and/or ability required. Reasonable accommodations may
be made to enable individuals with disabilities to perform the essential
functions.
Supervisory Responsibilities
No supervisory responsibilities.
Minimum Education/Experience
No educational requirement and 6 months to 1 year relevant experience
Required Licenses/Certifications
Healthcare Financial Management Association (HFMA): Certified Revenue Cycle
Representative (CRCR)
* Within 1 year of hire into job
Other Experience/Qualifications
Required:
* Strong aptitude with Microsoft Access
Preferred:
* Bilingual (Spanish)
* One to two years’ experience working with public and experience in patient
registration and/or hospital patient accounting office