Oncology Financial Navigator

The Oncology Financial Navigator is the key person responsible for the following: Initiation and coordination of pre-certification and prior authorization for patients with their insurance carrier; insurance and eligibility verifications and assessment of financial requirements of recommended cancer treatment; providing financial counseling to patients regarding insurance benefits, co-payments, and maximum out-of-pocket amount pertaining to cancer treatment; researching and securing drug replacement programs for chemotherapy/immunotherapy medications for eligible patients; determining patient eligibility for any Federal, State, and Pharmaceutical assistance programs; validation and coding of radiation charge entry daily; and working closely with the business office to ensure timely claim and account follow-up for Cancer Center patient accounts. The Oncology Financial Navigator is in constant communication with patients, providers, nursing staff, radiation staff, and third-party payers. The Oncology Financial Navigator must also have a functional knowledge of patient access and billing operations in the field of oncology and hematology.

Education, Work Experience and Licensure:

• Associates Degree in Medical Coding or related field required. Related work experience with Coding, billing and insurance precertification may qualify in lieu of education. 


• Bachelor’s degree preferred


• Project Management Experience preferred


• Minimum of five years medical business office experience with insurance procedures and patient interaction required (delete)


• Experience in medical billing and insurance pre-certification preferred


• Strong (delete) knowledge of diagnostic ICD-10 procedural (CPT) coding and cancer terminology


• Prior experience supporting the Revenue Cycle systems utilized at Holzer Health System preferred (delete)


• Basic Microsoft Office computer skills including word processing and Outlook


• Or other experience as deemed appropriate by Director