Financial Advocate

St. Charles Health System•Bend, OR

6d•$22 - $30•Hybrid

About The Position

The Cancer Center Financial Advocate at St. Charles Health System partners with patients and families to ensure understanding of the financial aspects of cancer treatment for hospital and professional services. This includes insurance verification, benefit education, cost estimation, preauthorization, and connection to assistance programs in alignment with best practice standards. The Financial Advocate coordinates and tracks financial services across the patient’s continuum of care, proactively removing financial barriers to treatment. This role collaborates closely with clinical, revenue cycle, pharmacy, and support service teams. This position does not directly manage any other caregivers.

Requirements

High school diploma or GED.
Minimum one (1) year of experience in healthcare, hospital, clinic or medical insurance billing office.

Nice To Haves

Two years of college or technical degree.
Certified Healthcare Financial Professional (CHFP) or similar certification.
Oncology or revenue cycle–related certifications.
Two (2) or more years of experience in hospital, oncology, clinic, or medical billing environment.
Experience with: Oncology EMR systems (e.g., Mosaiq, Aria, Epic), Insurance verification and authorization processes.

Responsibilities

Verifies patient insurance eligibility and coverage. Determines co-pay, deductible, co-insurance, and maximum out-of-pocket amounts in accordance with St. Charles Health System credit and collection guidelines.
Maintains advanced working knowledge of Medicare, Medicaid, Commercial, Managed Care, and HMO plans. Stays current on payer policies, authorization requirements, and regulatory changes.
Provides accurate, timely cost estimates for Cancer Center services using available estimation tools and payer-specific benefits.
Obtains and coordinates prior authorizations and referrals for all services ordered by Cancer Center providers, ensuring compliance and minimizing delays in care. Track authorization expirations, regimen changes, surgical scheduling timelines, and progression to prevent treatment delays.
Identify and resolve insurance barriers that impact reimbursement eligibility for infusion, radiation, and surgical oncology services.
Coordinate peer-to-peer review support with providers when required.
Maintains awareness and application of CPT and ICD-10 coding relevant to oncology services to support authorization and billing processes.
Interpret NCCN-guided treatment pathways and payer oncology policies to ensure alignment with medical necessity requirements
Identifies and assists eligible patients with internal and external financial assistance programs, including but not limited to: Free drug and replacement drug programs and Manufacturer assistance programs.
Collaborates with pharmacy and clinical staff to receive, document, log, and maintain inventory of medications obtained through assistance programs in accordance with compliance standards.
Refers patients to St. Charles Health System Financial Assistance Program and ensures timely distribution and completion of applications.
Assists with review, tracking, follow-up, and resolution of denied claims related to authorization or coverage issues.
Demonstrates strong analytical and problem-solving skills, including accurate calculation of financial responsibility.
Supports the organization’s vision, mission, and values in all activities
Actively participates in Lean initiatives and continuous improvement efforts.
Maintains a safe environment for patients, caregivers, and visitors.
Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.
Delivers excellent customer service with professionalism, compassion, accuracy, and timeliness.
May perform additional duties of similar complexity within the organization, as required or assigned.