Massachusetts Veterans Jobs

\$ 3,000 Sign-On Bonus for External Candidates If you are in WORCESTER, MA, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges. Serves with a team working with patients on coverage for medications in the Oncology/Infusion and clinic setting. The Financial Navigator (FN) helps patients analyze the best health insurance options available to them, taking into consideration their specific health concerns and financial situation. The FN then assists in getting the patient into that plan, be it connecting them up with a Medicare broker or signing them up for Masshealth directly. For patients where financial toxicity due to healthcare issues is still a concern, the financial navigator facilitates other resources such as foundational assistance, free drug, discounts, and other support. Works closely with the clinical staff, pharmacy services and billing department. Maintains a solid understanding of healthcare insurance policies, drug information, medical benefits, medical terminology and pharmacy benefits. This is a full time position, Monday -Friday. Employees are required to work our normal business hours of 8:00am ? 4:30pm OR 5:00pm. It may be necessary, given the business need, to work weekends. Our office is located at 5 NEPONSET STREET, Worcester, Massachusetts. Employees will be required to work some days onsite and some days from home. We offer weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment. *All Telecommuters will be required to adhere to UnitedHealth Group?s Telecommuter Policy. Primary Responsibilities Has an understanding of the care of the cancer patient, including treatment plans. Review patient chemotherapy protocols and determine insurance benefits and patient responsibility. Verify eligibility and benefits for all new patients and existing patients receiving treatment. Able to effectively communicate with patients newly diagnosed with cancer who may be emotional, angry, overwhelmed and/or frightened. Has a strong knowledge of healthcare insurance guidelines, programs and plans, patient assistance programs, co-pay assistance programs, Medicare health plans, Medicaid plans, COBRA guidelines and Healthcare reform. Works with patients to help understand and optimize their health insurance and supplemental coverage options for medical and pharmacy benefits. Verifies current insurance coverage, including out-of-pocket costs, deductibles, and/or coinsurance as necessary. Assist patients with insurance questions or denials. Assess patient need for outside assistance with medical care payments and if so, what programs might be available for individual patients, i.e. pharmaceutical, copay assistance, etc. Establish payment arrangements with the patient and document appropriately in the practice management system co-insurance assistance, etc. Assists patients with enrolling in Medicaid and other government-sponsored healthcare assistance programs. Acts as the patient?s direct primary point of contact for all insurance and billing inquiries. Possess strong research and problem solving skills. Demonstrates a high level of initiative and ability to self-direct to solve financial problems of patients. May need to work collaboratively with the cancer team to adjust care accordingly. Work with billing team on denied, no authorization, no referral claims, and provides feedback and follow up to clinical areas. Discuss payment arrangements with patients for outstanding patient balance. Properly document appropriate information in the Patient EMR. Process additional information requests and coordinate requests for letters of medical necessity from and to insurance companies. Direct day-to-day contact with Providers to assure treatments are approved before administering. Complies with health and safety requirements and with regulat ry agencies such as DPH, etc.