Financial Advocate

Jefferson Health Plans • Philadelphia, PA

3d • Onsite

About The Position

The Financial Counselor supports patients receiving outpatient oncology and infusion services by explaining insurance benefits and out-of-pocket responsibilities and developing appropriate financial plans. The role assists patients with patient assistance and drug copay programs, including copay foundation applications, to establish eligibility for external assistance and internal financial support. When needed, the counselor facilitates and submits Medical Assistance applications, including Adult Category, Healthy Horizons, BCCPT, Emergency Medical Assistance, and MAWD, to help maintain access to treatment.

The position requires knowledge of healthcare insurance, hospital and physician claims, insurance payments, and patient financial responsibility. The counselor manages oncology patient assistance programs, coordinates with medical oncology teams and leadership to resolve verification, registration, and benefit issues, and uses Excel and other systems to track financial assistance. The role also requires compliance with payer requirements, HIPAA, and internal protocols, while demonstrating professionalism and the hospital's core values.

Requirements

• High school diploma or GED.
• Thorough understanding of healthcare insurance plans, including Medicare, Medicaid, and commercial payers, and the ability to interpret benefits and patient responsibilities.
• Knowledge of oncology patient assistance programs, including enrollment, copay card applications, foundation support, and manufacturer-sponsored programs.
• Knowledge of state and federal financial assistance programs, including Medical Assistance categories, with the ability to complete and submit applications accurately.
• Ability to analyze hospital and physician claims and assist with post-insurance financial support.
• Strong computer skills, including Microsoft Excel, electronic medical records, and payer portals; ability to navigate multiple systems simultaneously.
• Exceptional communication and interpersonal skills to explain complex information and collaborate with clinical and administrative teams.
• Strong organization and attention to detail, with the ability to prioritize tasks in a high-volume, time-sensitive environment.
• Professional, patient-centered approach, including empathy and discretion when handling sensitive financial concerns.
• Adaptability and problem-solving ability when navigating changing payer policies and assistance guidelines.
• Commitment to respectful and effective interactions with patients, families, coworkers, and external partners.

Nice To Haves

• Associate degree in Business or Healthcare; relevant work experience may be considered in lieu of the degree.

Responsibilities

• Meet with patients to communicate insurance benefits and out-of-pocket responsibilities and develop appropriate financial plans.
• Provide direct financial support to patients receiving outpatient oncology and infusion services.
• Manage oncology patient assistance programs, including enrollment, submitting claims after insurance payments, and staying current with program and insurance policy changes.
• Assist with copay programs, foundation applications, and manufacturer-sponsored assistance to secure financial support.
• Facilitate and submit Medical Assistance applications, including Adult Category, Healthy Horizons, BCCPT, Emergency Medical Assistance, and MAWD.
• Communicate with the Medical Oncology team and leadership to resolve verification, registration, and benefit coordination issues.
• Analyze hospital and physician claims to determine patient responsibility and identify post-insurance financial support options.
• Use Excel and multiple systems to track and manage patient financial assistance.
• Comply with payer requirements, HIPAA regulations, and internal protocols.
• Explain complex financial and insurance information to patients and collaborate with clinical and administrative teams.

Benefits

• Medical insurance, including prescription coverage
• Supplemental insurance
• Dental insurance
• Vision insurance
• Life and AD&D insurance
• Short- and long-term disability
• Flexible spending accounts
• Retirement plans
• Tuition assistance
• Voluntary benefits, including access to group insurance rates and discounts
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service
• Medical insurance, including prescription coverage, for all colleagues, including those who work less than part-time

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED