Benefit Navigator (Onsite)

Job description

Adventist Health Sonora has been one of the area's leading healthcare providers since 1900. We are comprised of a 72-bed hospital, 30 medical offices, comprehensive cancer care and a vast scope of award-winning services located throughout Tuolumne and Calaveras counties and the surrounding areas. Sonora is known for its friendly hometown charm, vast outdoor experiences and lively downtown. The allure of Sonora's close-knit community is complimented by its proximity to Yosemite National Park, as well as just a quick drive to Lake Tahoe.
Job Summary:
Serves as the subject matter expert (SME) for insurance questions from associates, ancillary depts, and/or patients. Manages patient responsibility estimates and POS collections. Assists with financial assistance application completion, submission and approval. Partners with Medicaid eligibility vendor. Collects and/or creates cash deposits and provides change to departments. Acts as the point of contact for patient questions regarding insurance explanation of benefits, payments, and itemized statements. Provides cross coverage to patient access departments including other sites.
Job Requirements:
Education and Work Experience:
• High School Education/GED or equivalent: Required
• Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred
• Five years' patient access experience: Preferred

Essential Functions:
• Completes accurate and timely benefit review and determination of patient financial liability including eligibility for charity care.
• Collects expected patient responsibility or makes payment arrangements to collect that amount. May be responsible for reviewing and processing of financial assistance applications. Works collaboratively with care management department.
• Educates patient on insurance benefits, available payment options, and internal/external assistance programs including providing Medicaid and/or financial assistance application. Assist patients with EOB explanations and other insurance/account questions.
• Collaborates with financial counseling stakeholder if patient is eligible for government assistance programs or hospital charity care.
• Provides cross coverage and training, when needed, for other team members.
• Performs other job-related duties as assigned.

Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.