Lead Patient Financial Counselor - Clinical Program Services

Providence•Spokane, WA

7d•Onsite

About The Position

Under the direction of the Practice Director/Manager, this role assists with work queues by monitoring activity related to timely resolution for hospitals, clinics, pharmacies, and insurance companies. It escalates issues and concerns to management as needed, trains new employees, and manages the daily workflow of financial counseling team members. The Lead Patient Financial Counselor acts as a liaison between the Financial Counseling team and management, monitors and educates on controllable denials, and obtains payer authorizations. This role verifies coverage and benefit information for procedures performed at INWA, maintains NCCN competency with payer regulations and requirements to ensure optimum reimbursement for INWA providers, and assists patients with co-pay and financial assistance for underinsured and non-insured patients receiving chemotherapy and secondary drugs. It also supports patient services in obtaining prior authorizations for services ordered by INWA providers as needed, assists customers with signing up for available Medicaid programs, and helps customers with the insurance exchange program during open enrollment season. Additionally, this role collects deposits from high-deductible patients and explains the financial assistance program for customers who do not qualify for insurance. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Care Region and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we Providence know that to inspire and retain the best people, we must empower them.

Requirements

2 years of customer service (including public interaction)
2 years of Infusion authorization experience
2 years of experience with medical and health plan terminology including CPT, ICD‑9, and ICD‑10 coding
Washington State and Oregon Exchange Regulations and Medicaid process experience
Experience working within a medical specialty environment

Nice To Haves

2 years of experience with prior authorization, medical insurance, and third-party payer requirements
Experience with EPIC and or a similar Electronic Medical Record (EMR) system
2 years of oncology experience
Data entry and computer experience
Proficiency with Microsoft applications such as, Outlook, Teams, Word, and Excel
Ability to work independently and stay organized

Responsibilities

Assists with work queues by monitoring activity related to timely resolution for hospitals, clinics, pharmacies, and insurance companies.
Escalates issues and concerns to management as needed.
Trains new employees and manages daily workflow of financial counseling team members.
Acts as a liaison between Financial Counseling team and management.
Monitors and educations on controllable denials.
Obtains payer authorizations, verifies coverage and benefit information for procedures performed at INWA.
Maintains NCCN competency with payer regulations and requirements to ensure optimum reimbursement for INWA providers.
Assists patients with co-pay and financial assistants for underinsured and non-insured patients receiving chemotherapy and secondary drugs.
Supports patient services in obtaining prior authorizations for services order by INWA providers as needed.
Assists customers with signing up for any Medicaid programs available within our community.
Assists customers with the insurance exchange program during open enrollment season.
Collects deposits from our high-deductible patients.
Explains the financial assistance program for customers that do not qualify for insurances.

Benefits

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.

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