Covenant Health

Oncology Financial Navigator, Administration

Full Time, 80 Hours Per Pay Period, Day Shift

Thompson Cancer Survival Center Overview:

Thompson Cancer Survival Center is our region’s largest cancer-fighting network, with more imaging centers, more board-certified physicians and surgeons, and more cancer and radiation centers closer to where you call home. And, we are a proud member of Covenant Health, our region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division.

Thompson Cancer Survival Center (TCSC) was founded to bring world-class cancer care to East Tennessee. At Thompson, leading cancer specialists use the most advanced technologies to achieve breakthrough successes in treating many types of cancer. Our doctors have the support of a complete team: Dieticians, genetics counselors, physicists, pharmacists, therapists, technologists, oncology nurses, social workers and others are all there to treat – and beat – the disease.

Therapies pioneered at Thompson have transformed and saved the lives of hundreds of East Tennessee cancer patients, while progressive clinical trials have brought the most advanced new cancer medicines to this area. In addition to the original downtown location, there are TCSC facilities in West Knoxville, Oak Ridge, Sevierville, and Morristown.

Position Summary:

The role of the Oncology Financial Navigator is to work with patients and their families to help them reduce stress or hardships related to the cost of treatment for their medical condition based upon individual needs. The Financial Navigator is responsible for performing assessments on all oncology patients and meeting with them to present a financial plan that demonstrates patient responsibility for treatment including seeking up-front payments and arranging payment plans before patients begin treatment.

This role will help patients understand their co-pays, deductibles and out-of-pocket expenses as well as what their health insurance plans may cover. Financial Navigators help patients set up payment plans, find cost-saving methods for treatments, and improve access to healthcare services. The Navigator will research and enroll eligible patients into financial assistance programs from all available internal and external resources, including but not limited to: TennCare, copay assistance programs, drug replacement programs, grants from national oncology foundations and the Covenant Health Financial Assistance Programs.

Recruiter: Sarah Grey || sgrey1@covhlth.com || 865-374-5271

• Prior to a patient’s first appointment, obtains preliminary diagnosis, insurance coverage information and demographics.
• Coordinates proper insurance verification information/documentation of patient’s insurance, to be used to estimate the patient’s financial responsibility.
• Based upon diagnosis, estimates insurance coverage, financial obligation, and completes patient cost estimate forms.
• Develops a standard estimate based on a normal course of treatment for the particular diagnosis.
• Assess patient’s ability to meet expenses and discusses payment arrangements.
• Meets with patients and caregivers to provide patient-specific education on their insurance coverage, cost of treatment, and patient financial responsibility prior to appointments.
• Educates patients on financial assistance programs as needed as well as identify sources of aid and help with completing forms.
• Reviews reimbursement and patient responsibility forms with patient and obtains approval signatures.
• Assists patients with questions regarding billing and insurance payments.
• Assists patients in applying for alternative payment programs, including but not limited to, medical assistance, drug replacement programs, COBRA, and charity care.
• Stays current on available financial aid, develops professional relationships with financial aid providers, and networks with financial aid providers to obtain leads to other aid programs.
• Maintains database for Third Party Assistance (TPA) Programs for oncology patient financial assistance and continuously monitors for changes and/or updates regarding each TPA’s available funding and their eligibility and enrollment requirements.
• Helps patient complete applications for financial assistance, pharmaceutical assistance, and government programs in a timely and HIPAA compliant manner. Works closely with the Oncology Social Workers on cross over patients and make referrals as necessary.
• Tracks all TPA funding received and reports the information to the VP Oncology on a monthly basis. Reports trends and forecasts on special projects as requested by VP Oncology.
• Serves as the oncology point of contact for all patient billing questions and concerns.
• Maintains close communication with Business Office to ensure that correct information is obtained for billing and reimbursement.
• Reviews registration records to ensure that all insurance and other pertinent information needed for correct billing was obtained; makes corrections as needed.
• Works with Social Services, Nurse Navigators, Physician Office Staff, obtains insurance benefits and pre-certification as needed.
• Demonstrates patient responsibility for treatment including seeking up-front payments and arranging payment plans before patients begin treatment.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education:           

Use education reference sheet (unless Exempt or education verification exception)

Minimum Experience:         

Business Office experience in a hospital setting; knowledge of insurance benefits and precertification requirements. 

Licensure Requirement:      

None