Patient Financial Navigator - Per Diem

The compensation range listed reflects the range Northern Light Health anticipates relying on in setting the wages for the position. The range may not necessarily include all additional compensation elements available, such as differentials, incentive programs and benefits. Northern Light Mercy Hospital Department: Cancer Care Position is located: Mercy Medical Office Building Work Type: PRN (Pool/Per Diem) Hours Per Week: Variable Work Schedule: Variable Salary Range : $21.18 - $30.51 Exempt: No Summary: Under the direction of the Manager of Oncology, the Patient Financial Navigator serves as a patient advocate, liaison, and educator to assist patients with understanding the cost of care and navigating the continuum of care; works in collaboration with other members of the health care team to identify patients with actual or potential financial burden. Provides financial counseling and assessment of need in advance of, during, and post receipt of services; evaluates patient insurance benefits and counsels on financial matters, including benefits, financial support, drug assistance, co-pay assistance, and other assistance programs. Helps with reimbursement for under or un-insured individuals. This person serves as a liaison between physicians, clinical team, patients, pharmacies, and contracted insurance plans. Works with health insurance providers to determine coverage, benefit limits, and financial responsibility and conveys this information to the clinical team, patient, and family. The Specialist will be instrumental in obtaining written documentation, tracking, and reporting outcomes. The Specialist will interface directly with medical staff, pharmacy, financial counselors, and billers to ensure a seamless process to the patients receiving outpatient treatments. Handles inquiries from customers regarding any aspect of services received or status of account and applies outstanding customer service skills daily. The incumbent may have access to highly confidential patient, employee and/or Mercy proprietary information, and must handle & protect the information in accordance with hospital & system policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position and conducts all job responsibilities according to the Mission and Values of Mercy Hospital. Responsibilities: Patient Navigation Acts as a centralized resource for patients and families to gain support and education regarding the anticipated financial impact of a cancer diagnosis and treatment. Educate patients on basics of their health insurance (co-pays & deductibles, in-network benefits, etc.). Work in collaboration with health care team to identify patients with actual or potential financial burdens so that additional assistance can be discussed with the patient and initiated as appropriate. Meets with patients prior to start of treatment and maintains communication with patients during their course of treatment, which includes assessment of financial need or distress, outlining and explaining financial obligations and billing process, establishing payment arrangements and review of financial assistance for planned treatment and or procedures.

• Demonstrates knowledge of drug replacement programs, grant programs, co-pay foundation programs, and other cancer-related patient support options. Processes and monitors applications for same and captures highest level of value to patient and institution. Maintains cumulative value record of same. Assess for eligibility for outside financial assistance (pharmaceutical companies, foundation, copay cards) assists with application and enrollment/reenrollment processes and conducts the necessary follow-up to ensure payment. Assists in the completion of patient related benefit, financial assistance, insurance, disability, Medical Necessity, Co-payment, and patient assistant program forms for patients to mitigate financial risk. Collaborates with patient accounts, and Hospital Financial Advocates to secure appropriate patient resources and mitigate financial risk to patient and organization.
• Provide information to patients and families to reduce anxiety and convey an attitude of acceptance, sensitivity, and caring.
• Maintain professional relationships and convey relevant information to other members of the healthcare team within facility and any applicable referral agencies. Assists patients and families with resolving financial, psychosocial, functional, and administrative issues by advising of options and referring to appropriate resources. Intervenes as appropriate to advocate for patient and family.
• Checks for EMR messages and notification regularly. Answers and researches any questions from providers, and clinical team. Monitors messages sent for inquiries related to billing, coding, or documentation.
• Documents all relevant data and correspondence in the appropriate locations and in the patient Electronic Medical record in a systematic and readily retrievable manner.
  2. Revenue Cycle: Ensure that all processes related to insurance eligibility and verification are performed prior to an individual patient financial meeting. Identify delinquent / high dollar account balances in accordance with the patient''''s treatment plan and ongoing account balances.
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  4. Answers questions or directs patients to appropriate resource for questions regarding insurance, billing, payment, and or collections arrangements.
  5. Work closely with patients and Patient Financial Services (PFS) to resolve account balance issues and establish payment plans.
  6. Interface directly with medical staff, pharmacy, Mercy Financial Counselors, and Patient Accounts to ensure a seamless process to patients receiving infusion and oral treatments.
  7. Maintains complete and accurate documentation and files of drug prior authorizations and renewals, and monies applied to accounts through co-payment assistance or drug replacement.
  8. Scans and indexes insurance correspondence, drug authorizations, consents, and other documents as appropriate.
  9. Notify billing department with any discrepancies or changes that have direct impact on reimbursement.
     2. Maintains a positive attitude and promotes a professional environment.
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     4. Maintains a positive attitude daily within the NL Mercy Cancer Care and Infusion Program. Provides excellent service by identifying customer needs and fulfilling customer expectations.
     5. Fosters teamwork and positive rapport within all departments to maximize achievement of goals
     6. Promotes a positive work environment.
     7. Continually engages in a teamwork setting. Collaborate with colleagues across the organization and external to the Program
        3. Performs additional duties as required or assigned. Other Information: Competencies and Skills Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed. Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization''''s benefit. Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences'''' level. Types at 60+ words per minute. (only to be used as a condition of employment) Ability to understand the language used to precisely describe the human body including its components, processes, conditions affecting it, and procedures performed upon it. Word processing, spreadsheets, data entry, database experience and other computer related skills. Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan. Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of belonging, empowerment, and cooperation. Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved. Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others. Required Experience 1 year/years of Relevant Work Experience Working Conditions Potential exposure to abusive and/or aggressive people. Work with computers, typing, reading or writing. Potential exposure to hazardous materials. Lifting, moving and loading 20 to 30 pounds. Potential exposure to noise levels being uncomfortable. Prolonged periods of sitting. Potential exposure to noxious odors. Potential exposure to very hot or cold temperatures.
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           Northern Light Mercy Hospital is a nonprofit acute care hospital in Portland, Maine, and a sponsored ministry of the Sisters of Mercy of the Americas. Our work is grounded in compassion, dignity, and service, with a commitment to caring for every member of our community, especially those most in need. At Mercy, people come to work knowing their role matters. Whether at the bedside, in support services, administration, or clinical care, every team member contributes to a culture built on respect, collaboration, and purpose. We provide a broad range of medical and surgical services, along with multiple primary and specialty care offerings and community-based programs that extend our impact beyond the hospital walls. As a member of Northern Light Health, an integrated statewide health delivery system, employees benefit from the stability, resource, and career pathways of a larger organization while working in a hospital that feels personal and connected. Team members have opportunities to grow professionally, explore new roles, and build long-term careers in an environment focused on quality, innovation, and the well-being of our workforce. Mercy Hospital is located in Portland, Maine's largest and most vibrant city, offering an exceptional quality of life that attracts people from across the country. Portland is nationally recognized for its food scene, arts and culture, vibrant neighborhoods, and strong sense of community. Within minutes of the city, you can reach beaches, islands, lakes, and mountain trails, with easy access to hiking, skiing, boating, and cycling. The region also offers excellent schools, family-friendly neighborhoods, and easy travel connections through Portland International Jetport and nearby rail service to Boston. Southern Maine blends career opportunity with a lifestyle centered on balance, outdoor recreation, and coastal living, making it an ideal place to live and build a career.

           Questions? Contact Talent Acquisition: phone: 207-973-7100 email: talentacquisition@northernlight.org

           Portland, Maine, Catholic, Sisters of Mercy, Level 2 NeoNatal Nursery