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+ Area of Interest: Patient Services

+ FTE/Hours per pay period: 1.0

+ Department: Organ Transplant- Meth

+ Shift: Mon-Fri, 8:00am-4:30pm

+ Job ID: 175735

Overview

SHIFT: Mon-Fri, 8:00am-4:30pm

The transplant financial navigator is a core member of the transplant team and assesses financial needs of pre and post-transplant patients. They formulate a financial plan to determine the cost of medications pre and post-transplants. This plan will enable individuals and their families to access appropriate services within the limits of available resources and achieve improved levels of health and functioning based on diminished financial barriers. This position works collaboratively with the multidisciplinary team and across the continuum of care to develop and implement a plan to provide coordinated care to improve outcomes for our transplant patients.

The financial navigator assesses patients’ financial and insurance information to assist patients and families in understanding their insurance benefits, what they can expect from their insurance and health providers, and what financial assistance resources may be available based on the patient’s individual situation. Determines Medicaid, Marketplace, other Community Resources, or UPH Financial Assistance Program as an option of last resort. Facilitates the actual insurance enrollment processes and counsels the patients as a certified application counselor. Collaborates with billing departments to assist in billing of transplant-related charges.

Interacts professionally and compassionately to ensure patients and their representatives’ needs are met and that they understand the hospital’s financial policy, through various payment and/or insurance options. Creating a position that allows us to assist our patients with all of their financial needs by providing a “one-stop shop” experience. Increases patient satisfaction by reducing duplication of efforts and not having them referred to another employee(s) to get the same results

Why UnityPoint Health?

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.   Here are just a few:

+ Expect paid time off, parental leave, 401K matching and an employee recognition program .

+ Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.

+ Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family .

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.

Find a fulfilling career and make a difference with UnityPoint Health.

Responsibilities

Patient Services:

+ Serves as point of contact to triage patients with high levels of financial distress.

+ Assists patients to access resources to ensure adherence to treatment plan.

+ Maintains comprehensive knowledge of community resources and acts as a liaison to appropriately link patients/families to financial services, health insurance, public assistance, and other resources.

+ Provides assistance in obtaining government entitlements; i.e. food stamps, Medicaid, SSI, SDI, Social Security, Medicare, FMLA.

+ Knowledgeable of local and national financial resources and identifies appropriate patients for hospital and foundation assistance programs.

+ Consistently utilizes a holistic approach considering physical, psychosocial, spiritual, educational, safety and related criteria appropriate to the age of the patients served.

+ Identifies and delivers culturally-competent interventions to patients/families to meet identified needs.

+ Serves as a patient/family advocate around concerns such as patient confidentiality, informed consent, patient autonomy, and self -determination.

+ Documents assessments, interventions, and referrals in the health record according to documentation standards.

+ Develops effective communication system with patients, navigation team, community resources, and referring physicians.

+ Counsels patients via phone or in person regarding financial barriers.

+ Assess patient’s financial/insurance information in order to determine insurance eligibility.

+ Follow up with Department of Human Services and all other Public Agencies regarding application progress.

+ Reviews Department of Human Services decisions for enrollment in applicable states.

+ Ensure that all follow-up with the Department of Human Services has been completed for and by the patient.

+ Assess patients/consumers for other Community Assistance Agencies.

+ Ensure that all options have been exhausted prior to the patient qualifying for Financial Assistance.

+ Works closely with the CBO to ensure that there is cohesiveness of processes and no duplication of efforts.

+ Educate patients, employees, and physicians regarding Medicaid and Marketplace place insurances that may be available.

+ Possesses excellent time management skills.

+ Completes and submits Medicaid and/or ACA Applications for patients that may potentially qualify in a timely and accurate manner.

+ Educates consumers/patients on Quality Health Plans, deductibles, out-of-pocket, government subsidies, etc.

+ Maintains, extensive and current, knowledge of Marketplace plans with Iowa and if appropriate Illinois, Nebraska, Wisconsin exchanges.

+ Completes annual CAC Training for UPH as well as CMS. Displays all Certificates, at all times, when assisting consumers in office or in person.

+ Provides fair, impartial, accurate information to assist consumers when submitting the eligibility application for a quality Health plan thru Healthcare.gov online or via phone.

+ Assists patients in completing UPH Financial Assistance Application as needed and forwards all appropriate documents to the CBO.

+ Inpatient rounding as a regulatory requirement with transplant team.

+ Pre and Post long term financial follow up to ensure adequate coverage.

Program Outreach/Advocate:

+ Serves as an advocate in the community for cancer health promotion activities.

+ Develops relationships with community partners to identify and optimize resources for high-risk patients/families.

+ Present financial coverage at Transplant Selection Committee.

Basic Program Functions:

+ Learns and maintains CMS and UNOS regulations related to the financial navigator role.

+ Understanding and maintaining the transplant referrals to ensure adequate insurance.

+ Data entry of all referrals.

+ Assist in billing of program as needed; bundled payments, service line billing.

+ Other duties as assigned.

Qualifications

Education:

+ Bachelor’s degree required – in re lated field preferred.

Experience:

+ Two or more yeaars relevant healthcare experience.

+ Experience in medical billing, coding, or insurance preferred.

Licensure/Certification:

+ Successful passing ABTC TFC Exam within two years of employment.

Knowledge/Skills/Abililties:

+ Writes, reads, comprehends, and speaks fluent English required.

+ Strong computer knowledge using word processing, spreadsheets, e-mail, and web browser required.

+ Ability to handle multiple interruptions and changing priorities required.

+ Performs effectively under stressful situaitons.

+ Exercises sound judgement, seeking advice when appropriate.

+ Must be able to work independently and assume responsibility for timely completion of assigned functions.

+ Must be able to communicate effectively with people of diverse professional, educational and lifestyle backgrounds.

+ Ability to maintain confidential information.

+ Ability to deal with people effectively, patiently and respond professionally in all situations.

+ Ability to understatnd and deal effectively with problems and opportunities.

+ Ability to work under time constraints.