Advanced Therapies Benefits Specialist (Financial Clearance)
About The Position
The Advanced Therapies Benefits Specialist manages and coordinates patient financial services so patients understand and can access financial resources from payers, manufacturers, and foundations. The role supports timely access to advanced therapies by verifying coverage, facilitating prior authorizations, counseling patients about costs and assistance options, and coordinating financial clearance with clinical and administrative teams. The specialist develops and executes benefits investigation and prior authorization pathways for products across Health System Partner service lines and therapeutic programs. When Letters of Agreement or Single Case Agreements are needed, the role partners with Managed Care and Payer Access teams to help secure patient access to treatment. The specialist also contributes to building a centralized Benefits Specialist function for current and future partners. This is a full-time, onsite position based in Tampa, working five days per week in the office and reporting to the SVP, Operations.
Requirements
- At least 5 years of experience in healthcare billing, insurance coordination, or patient financial counseling.
- Familiarity with healthcare financial systems and insurance verification processes.
- Strong communication and interpersonal skills for assisting patients.
- Attention to detail and strong organizational abilities.
- Proficiency with healthcare information systems.
- Prior experience or familiarity navigating payers for cellular therapy (CAR T, TIL, etc.), gene therapy, and/or bone marrow transplant patient journeys and applicable prior authorizations is preferred.
Nice To Haves
- Prior exposure to both inpatient and outpatient sites of care.
Responsibilities
- Investigate and verify patient insurance coverage and benefits with government and commercial payers, including out-of-state Medicaid agencies, PBMs, and TPAs, as early as possible in the care journey.
- Confirm patient eligibility and plan details, including site-of-care considerations, to support timely access to care, accurate billing, and fewer claim denials.
- Coordinate prior authorizations for applicable components of treatment plans with patients, clinical coordinators, clinical staff, payers, and other stakeholders.
- Guide patients through enrollment in appropriate benefit programs, such as Medicaid, Medicare, and other financial assistance options, and help with applications and program requirements when applicable.
- Explain insurance benefits, out-of-pocket costs, coverage details, and available financial assistance to patients, including site-of-care considerations.
- Collaborate with clinical staff, patient accounting, billing and collections, research, and other hospital departments to communicate benefit considerations, support financial clearance, and integrate financial factors into care planning.
- Work with manufacturers, in partnership with the team, to seek additional financial assistance when appropriate.
- Maintain accurate records of patient interactions, financial agreements, assistance provided, and financial counseling sessions while complying with healthcare regulations and privacy laws and protecting patient confidentiality.
- Develop and execute benefits investigation and prior authorization pathways tailored to products across partner health systems’ service lines and therapeutic programs.
- Partner with Managed Care and Payer Access teams to pursue Letters of Agreement or Single Case Agreements when needed to enable treatment access.
- Contribute to developing a centralized Benefits Specialist function for existing Health System Partners and future partners.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
