Genetics Financial Coordinator

Stanford Medicine Children's Health•Palo Alto, CA

2d•$43 - $54•Remote

About The Position

Under the direction of the PASC Authorization Assistant Manager, the Genetics Financial Coordinator (GFC) is responsible for providing accurate and professional financial clearance to patients seeking Genetic Testing Services at Stanford Children's Health. The GFC is responsible for the analysis, validation, and regulatory and compliance activities associated with the financial clearance process. The GFC mitigates the financial risk to Stanford Children's Health by performing an accurate financial clearance review along with a comprehensive analysis of patient and payer specific benefits and patient liability. Ensures that adequate compensation resources exist and recommends coverage plans that best meet the individuals' needs for Genetic Testing. Counsels Genetic Testing patients on financial considerations throughout their experience. Works with a multidisciplinary team consisting of patients, revenue cycle, physicians, nurses, social workers, and pharmacists.

Requirements

High School Diploma or GED equivalent
Three (3) years of progressively responsible and directly related work experience
Ability to communicate effectively both orally and in writing
Ability to maintain confidentiality with sensitive information
Ability to plan, organize, prioritize, multi-task, and meet deadlines
Ability to work effectively with individuals at all levels of the organization
Knowledge of basic mathematics
Knowledge of computer applications related to patient accounts processing
Knowledge of medical terminology
Knowledge of principles and practices of customer service and telephone courtesy
Knowledge of Windows-based office software, computers and operating systems

Responsibilities

Analyze benefit requirements and initiate the request for authorization/prior approval for the genetic testing including but not limited to: blood draw and lab sequencing and ensuring coordination of lab invoicing and billing
Analyze benefit requirements and initiate authorization, pre-certifications and /or pre-determinations for treatments
Analyze benefits for appropriate coverage for services. Review contracts and obtain clarification from managed care contracting and payer coordination as needed
Communicate with patients and family members prior to the time of Genetic Testing; inform patients of the anticipated costs of Genetic Testing costs, the anticipated patient liability, and the patient responsibilities; assist patients with a financial plan when not adequately funded for Genetic Testing (e.g. fundraising)
Work with Multidisciplinary team to develop agreements for International, self-funded patients, and patients with limited benefits
Interact with clinical teams and patient to obtain treatment plans, discharge planning, concurrent and retrospective review, and patient demographics to begin insurance verification process
Provide ongoing financial counseling based on each individual patient's benefits, patient financial interview, and calculated estimated expenses based on patient benefits
Tracks and maintains patient account records of interaction for accurate billing of Genetic Testing related services as necessary. Adheres to Genetic Testing policies and procedures as related to financial clearance. Coordinates these policies and procedures with those of Patient Financial Services.
Ongoing financial case management to analyze and review benefits and process patient referrals to external Genetic Testing programs as needed
Resolve any issues related to coverage and payment