Financial Counselor (Mon-Fri 8am-4pm)
About The Position
The Financial Counselor works under minimal supervision and independently as a patient advocate for patients and families receiving treatment at Perlmutter Cancer Center locations. The role investigates insurance coverage and payer requirements, educates patients about treatment benefits and financial responsibilities, and helps ensure patients have adequate insurance benefits or other funding for treatment. The counselor verifies the accuracy and completeness of financial, insurance, and demographic information; reviews accounts and treatment schedules; and obtains and maintains referrals, authorizations, and precertifications for chemotherapy and radiation treatment. The position also helps patients understand coverage and financial options, identifies potentially eligible assistance programs, communicates payer requirements to practice staff, and coordinates with internal departments, insurers, patients, families, employers, and external agencies. The schedule is Monday through Friday, 8:00 a.m. to 4:00 p.m. The position requires effective communication and collaboration across the organization.
Requirements
- High school diploma or equivalent.
- Good interpersonal skills, effective communication skills, and creative problem-solving ability.
- Extensive knowledge of payer and billing requirements.
- Ability to understand criteria for multiple payers.
- Ability to analyze and update accounts using electronic hospital and medical systems in accordance with standards and guidelines.
- Ability to maintain knowledge of ongoing changes in insurance requirements.
- Ability to help locate resources or assistance programs for which uninsured patients may be eligible.
- Ability to communicate effectively with all levels of the organization.
Nice To Haves
- Two to four years of healthcare customer service and health insurance experience.
- Prior EPIC experience.
Responsibilities
- Maintain patient status and authorization information based on treatment schedules and authorization criteria, keeping the DAR current from at least one week to as far as 30 days ahead as directed by management.
- Verify insurance coverage and obtain detailed benefit information, referrals, authorizations, and precertifications for treatment; maintain and renew authorizations as needed.
- Research insurance plans and confirm benefit eligibility, patient liabilities, policy clauses and riders, secondary payer information, and coordination of benefits.
- Review and interpret payer preauthorization requirements, complete online payer operations, and ensure required preauthorizations are in place.
- Provide relevant coverage and authorization information to hospital and professional billing specialists to support accurate billing.
- Secure documentation of insurance liabilities and resolve discrepancies by contacting patients, family members, employers, insurers, and other agencies.
- Interview and advise patients and families about coverage, financial responsibilities, and next steps for securing financial coverage.
- Refer patients to in-network providers when out-of-network authorization or agreements are unavailable; screen patients for Medicaid and financial assistance when other coverage cannot be secured.
- Assist patients with financial inquiries and direct billing inquiries to the appropriate hospital or professional billing contact when needed.
- Determine insurance liability, coordination of benefits, financial responsibility, and primary and secondary insurance eligibility; review and address third-party coordination-of-benefits discrepancies before billing.
- Handle insurance questions and obtain information from physicians, patients, patient advocates, payers, and outside agencies by telephone, mail, or in person.
- Communicate financial information and payer requirements to practice staff during consultations, patient inquiry calls, and treatment schedule reviews.
- Monitor and update insurance data, authorizations, reauthorizations, treatment authorization changes, and same-day clearance information.
- Identify patients with nonparticipating insurance referred for outpatient treatment after hospital discharge and forward information to management for coordination with Managed Care.
- Perform other duties and special projects as assigned, follow organizational service standards, collaborate with staff and departments, and share information and constructive feedback.
Benefits
- Comprehensive benefits and wellness package.
- Financial security benefits.
- Generous time-off program.
- Employee resource groups for peer support.
- Employee wellness program covering physical, mental, nutritional, sleep, social, financial, and preventive-care well-being.
- Resources and services intended to support employees and their families at different life stages.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
