Evaluate patient financial situations and guide them through available support options.
Verify insurance coverage and explain benefits to patients.
Assist with financial aid applications and payment plan setup.
Handle Patient Billing inquiries with confidence, escalating only for complex situations.
Collect payments, explain out-of-pocket costs, and provide information on self-pay pricing.
Refer patients to appropriate financial assistance programs with confidence.
Maintain accurate records and ensure compliance with healthcare regulations.
When requested, provide administrative support for department(s).

High school diploma or GED
Associate's or Bachelor's degree in healthcare administration, business, or related field preferred
2+ years of experience in healthcare billing, insurance coordination, or patient financial services
Experience with Microsoft Office (especially Word and Excel)
Experience with payer portals and claim tracking systems
Familiarity with HIPAA compliance and healthcare privacy regulations
Experience working with CRMs (i.e., Salesforce) and Billing Software (i.e., Epic, XiFin, Quadax)
Strong understanding of health insurance plans, benefits, and coverage verification processes
Proficiency in explaining complex financial and insurance information to patients in a clear and empathetic manner
Ability to assess patient financial needs and recommend appropriate payment plans or financial assistance options
Experience with billing systems, insurance pre-authorizations, and payment collection procedures
Familiarity with self-pay pricing structures and assistance program referrals
Excellent communication and interpersonal skills to liaise effectively between patients, providers, and hospital staff.

Patient Financial Navigation Specialist

Key skills