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The Patient Financial Navigation Advisor (PFNA) acts as the patient’s liaison from physician order through complete billing cycle. The PFNA will complete a comprehensive analysis of patient’s health insurance to include verification of benefits, prior authorization status and patient’s out of pocket liability.
PFNA will educate and provide patient with a clearly defined estimate of the patient’s financial responsibility for all services, including office visits, testing, diagnostic studies, surgeries and procedures via phone, written correspondence and MyChart communication. PFNA will collect or provide payment arrangements in accordance with policies and procedures.
Financial screening process encompasses any or all of the following job functions:
- Financially screens insured patients prior to inpatient and outpatient services including office visits, testing, diagnostic studies, surgeries and procedures by verifying patient insurance eligibility and registering insurance information into the EPIC system when needed.
- Reviews patient history involving past illnesses, treatment locations, diagnosis and final outcomes when CPT codes are not available.
- Determines outstanding patient responsibility for hospital and physician charges to include past due liabilities in all communication to the patient.
- Creates financial estimate by providing insurance based out-of-pocket liability estimates for patients scheduled for outpatient and inpatient elective procedures.
- Establishes contact with the patient.
- Educates patient on out-of-pocket financial responsibilities including copay, deductible, coinsurance and out-of-pocket maximums.
- Attempts to collect payment in full prior to date of service or documents in EPIC patient will pay at time of service for Patient Services Representative to collect during registration process.
- Makes payment arrangements where applicable.
- Serves as PFNA throughout billing cycle.
- Verifies active Auto and Workers’ Compensation claims in relation to patient treatment plans.
- Monitors Work Queue accountabilities for estimates that need to be completed to balance the patient’s needs, individual performance goals and avoid delays in communication of patient financial liabilities.
- Provides clear and concise documentation in Epic to ensure precise throughput of patient financial liability information.
- Uses professional, clear, concise, and customer-friendly communication at all times to internal customers, providers and patients.
- Provides a stellar experience to Cooper patients; is proactive in serving patients and acts responsibly in the patient and Cooper’s best interest.
- Resolves patient challenges by offering alternatives with minimum escalation or support, trying to retain patients within the Cooper network.
- Performs all process and system-related functions in accordance with training and quality guidelines.
- Perform all related duties or special projects as assigned/required.
- Regular, consistent and punctual attendance required, following Cooper time and attendance policies.
- Must display a genuine interest in providing an excellent Customer Experience that aligns with Cooper’s business goals related to patient access throughout the Cooper landscape.
Provides psychosocial assessments, crisis intervention, social work consultation, referrals, short term crisis counseling to facilitate discharge plans, and/or adjustment to illness, and complex discharge planning for patients and their families.
Functions as a member of the Utilization Management team.
Responsible for MSW field instruction for Rutgers University School of Social Work.
Provides supervision to BA/BSW staff, LCSW's provide clinical supervision to LSW staff, as assigned by the Director of Utilization Management.
- Assists the Clinical team in providing indirect patient care, plus has non patient care responsibilities.
- Contributes to quality patient care by serving as a significant member of the health care team.
Responsible for registration functions (such as registration, insurance verification, patient safety and compliance, revenue collections, resource referrals, and customer service)in a fast paced, high volume Emergency Department that provides 24/7 service.
Patient Navigators provide a single and centralized point of patient access to physician and radiology services across disciplines. This includes Internal and Family Medicine, Pediatrics, Orthopedics, Cardiology, OB/GYN, Endocrinology, Rheumatology, Gastroenterology, and Pain Management
Patient Navigators thrive on working in a fast paced environment, have a strong ability to multi-task, are technically savvy, service oriented, communicate effectively and consistently display a professional demeanor.
Delivers an exceptional experience to patients, customers and physicians who contact the Access Center by facilitating patient access throughout Cooper’s provider network
The Registered RN is a professional care-giver who, as a member of a multidisciplinary health care team, assumes responsibility and accountability for a group of patients for a designated time frame and who supervises and provides care to these patients utilizing the nursing process including the therapeutic use of self.
Additional Responsibilities:
- Follows established policies and procedures.
- Communicates openly with internal customers and supervisors.
- Provides excellent customer service interfacing well with all levels of staff, management and physicians.
- Applies Cooper core values.
- Assumes responsibility and accountability for a group of patients for a designated timeframe.
- Evaluates patients, implements and documents nursing care.
- Assists physicians during examinations and procedures.
- Performs various patient tests and administers medications utilizing the nursing process.
- Promotes patients' independence by establishing patient care goals and teaching patients and families to understand conditions, medications, and self-care skills.
Carries out procedures for department functions, including, but not limited to:
- Assists anesthesia department with daily preparation for cases, room turnover, restocking of supplies, cleaning of equipment and other duties as noted in job description.
- Assist sterile processing technician with duties as assigned.
- Assist supply coordinator with duties as assigned.
Follows established policies & procedures.
Communicates openly with internal customers and supervisors.
Provides excellent customer service interfacing well with all levels of staff, management,
and physicians.
Applies Cooper core values.
Other duties as required
A nonexempt position responsible for performing a variety of duties in various ambulatory
settings, including primary, multi-specialty, specialty practices.
May be involved in both the clinical and administrative areas including assisting providers
with patient care, and handling clerical, environmental, and organizational tasks.
Provides information to patients so they may fully utilize and benefit from the clinical
services.
Maintains working knowledge of regulatory standards and is accountable to sustain these
standards in daily operations.
Clinical direction, oversight and competency review is provided by medical providers and
ambulatory professional development team in coordination with office management.
The Registered RN is a professional care-giver who, as a member of a multidisciplinary health care team, assumes responsibility and accountability for a group of patients for a designated time frame and who supervises and provides care to these patients utilizing the nursing process including the therapeutic use of self.
Additional Responsibilities:
- Follows established policies and procedures.
- Communicates openly with internal customers and supervisors.
- Provides excellent customer service interfacing well with all levels of staff, management and physicians.
- Applies Cooper core values.
- Assumes responsibility and accountability for a group of patients for a designated timeframe.
- Evaluates patients, implements and documents nursing care.
- Assists physicians during examinations and procedures.
- Performs various patient tests and administers medications utilizing the nursing process.
- Promotes patients' independence by establishing patient care goals and teaching patients and families to understand conditions, medications, and self-care skills.
The Registered RN is a professional caregiver who, as a member of a multidisciplinary health care team, assumes responsibility and accountability for a group of patients for a designated time frame and who supervises and provides care to these patients utilizing the nursing process including the therapeutic use of self.
Additional Responsibilities:
- Follows established policies and procedures.
- Communicates openly with internal customers and supervisors.
- Provides excellent customer service interfacing well with all levels of staff, management, and physicians.
- Applies Cooper core values.
- Assumes responsibility and accountability for a group of patients for a designated timeframe.
- Evaluates patients, implements, and documents nursing care.
- Assists physicians during examinations and procedures.
- Performs various patient tests and administers medications utilizing the nursing process.
- Promotes patients' independence by establishing patient care goals and teaching patients and families to understand conditions, medications, and self-care skills.