Patient Financial Advocate

Southwest Womens Oncology/Optimum•Albuquerque, NM

3d•Onsite

About The Position

A cancer diagnosis changes everything. And for many patients, the financial reality of treatment can be as overwhelming as the diagnosis itself. The Patient Financial Advocate stands between patients and that confusion-translating the complexity of insurance, billing, and financial assistance into clarity, confidence, and relief. This role is not administrative support. It is a critical function that protects patients from preventable financial hardship and protects the practice through revenue integrity and compliance precision. We believe that financial advocacy done right is an act of compassion and we hold it to the same standard as clinical care. We hire for attitude and aptitude above all else. Credentials matter, but who you are and how you grow matter more. Southwest Women's Oncology (SWWO) is New Mexico's leading gynecologic oncology practice, delivering advanced cancer care with skill, courage, and compassion. Optimum Human and Optimum Infusion extend that mission into performance medicine, infusion services, longevity, recovery, hormone optimization, medical weight loss, peptide therapies, hyperbaric medicine, aesthetics, and human performance. Together, we operate as a single integrated platform committed to one mission: We exist to deliver new possibilities in medical care, human performance, and health by uniting passion, knowledge, and skill. This is not a "explain the bill and move on" role. You will serve as the primary financial navigator for patients across both practices, working at the intersection of revenue cycle integrity, compliance, and patient advocacy. You will own the financial clearance process from pre-service through resolution-educating patients, securing assistance, facilitating collections, and ensuring nothing falls through the cracks. You will work alongside: Clinical teams managing active oncology and infusion treatment plans, Billing and coding staff navigating complex insurance and reimbursement workflows, Front office teams coordinating patient scheduling and financial intake, Pharmaceutical manufacturers, foundations, and assistance programs, Compliance and regulatory frameworks including the No Surprises Act. You will be the person patients trust when they don't know where to turn-and the professional the practice relies on to get it right.

Requirements

2+ years of experience in medical billing, revenue cycle management, or healthcare financial counseling.
Strong understanding of insurance benefits, EOB interpretation, and patient responsibility calculations.
Working knowledge of the No Surprises Act and Good Faith Estimate requirements.
Familiarity with Medicare, Medicaid, and commercial insurance plans.
Excellent interpersonal and communication skills with the ability to discuss sensitive financial matters with empathy and confidence.
Highly organized with strong analytical and problem-solving skills.
Proficiency with EMR, billing, and practice management systems.

Nice To Haves

Experience in oncology or infusion billing.
Experience securing manufacturer copay assistance, drug replacement programs, and foundation funding.
Familiarity with chemotherapy and specialty drug reimbursement workflows.

Responsibilities

Review patient accounts and insurance coverage prior to treatment to identify financial risk and outstanding balances.
Generate and deliver Good Faith Estimates (GFEs) in compliance with the No Surprises Act and applicable federal regulations prior to initiation of services.
Provide accurate cost estimates for chemotherapy, infusion therapy, surgical procedures, and specialty services.
Educate patients on insurance benefits, deductibles, coinsurance, and out-of-pocket responsibility with clarity and compassion.
Facilitate point-of-service collections and establish structured payment arrangements when appropriate.
Monitor outstanding balances and follow up proactively to resolve accounts in a timely manner.
Collaborate with billing staff to ensure financial workflows and documentation are accurate and complete.
Proactively identify and secure financial assistance on behalf of patients, including manufacturer copay assistance programs, drug replacement programs, foundation grants, and charitable funding resources.
Assist patients in completing required applications and gathering supporting documentation.
Monitor and manage awarded assistance funds, ensuring proper allocation to patient accounts.
Serve as a patient-centered resource for financial navigation throughout the entire course of treatment.
Partner with clinical, billing, and front office teams to ensure seamless financial workflows.
Communicate proactively with the care team regarding financial barriers that may impact treatment adherence.
Maintain strict adherence to HIPAA and all applicable federal and state compliance requirements.
Document all financial counseling interactions, assistance applications, and account activity accurately and completely in the EMR and billing systems.
Identify and recommend process improvements to enhance financial clearance workflows and patient outcomes.
Stay current on changes to insurance regulations, the No Surprises Act, and financial assistance program availability.
Raise standards through your example, your thoroughness, and your ownership.