Patient Financial Counselor

OneOncology

About The Position

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: The Proton Therapy Financial Counselor is responsible for guiding Proton therapy patients through their financial journey, serving as their primary contact throughout the entire treatment process. This includes educating patients about their insurance coverage, explaining potential out-of-pocket costs, setting up payment arrangements, and discussing financial assistance options. The role plays a critical part in onboarding Proton therapy patients, collaborating with the clinical team, and ensuring accurate out-of-pocket assessments. This specialized position requires excellent communication skills to ensure patients understand their financial responsibilities in a compassionate and clear manner.

Requirements

Highly skilled in interpreting, adapting, and applying insurance policies and clinical guidelines in relation to medical billing.
Working knowledge of government and managed care benefit structures.
Strong understanding of medical terminology.
Solid knowledge of medical terminology and radiation oncology procedures, with specific emphasis on Proton therapy.
Proficiency in prior-authorization processes, with the ability to communicate any delays or issues to patients effectively.
Exceptional verbal and written communication skills, with the ability to explain complex financial concepts clearly.
Ability to recognize, evaluate, and solve problems.
Ability to work collaboratively with a diverse group of individuals including physicians, patients, and insurance providers.
Strong organizational and time management skills.
Ability to work independently and manage multiple priorities in a fast-paced environment.
Proficiency with medical billing software and Microsoft Office applications (Word, Excel, Outlook).
High school diploma or equivalent required.
Minimum of 3 years of experience working with financial counseling and/or AR collections, preferably in an Oncology healthcare setting.
Radiation Oncology and/or Proton experience, required.

Nice To Haves

Bachelor’s degree preferred.

Responsibilities

Educate patients about their insurance coverage and benefits, including deductible, copay, coinsurance, and estimated out of pocket costs for Proton therapy and other standard radiation oncology treatments.
Review and interpret insurance policies, including ERISA regulations, to ensure compliance with the requirements for Proton therapy treatments.
Assess if patients’ insurance requires participation in the Cancer Registry to meet insurance conditions and clearly communicate this to the patient.
Determine the patient’s financial capacity to pay for treatment and communicate with the clinical team regarding feasibility of coverage for Proton therapy.
In cases where insurance coverage for Proton therapy is unlikely, prepare and send a detailed letter about the Expedited Care program, while personally contacting the patient to discuss options.
Stay current on Proton therapy coverage and policy guidelines to ensure patients are provided with precise information relating to the probability of coverage and potential cost of treatment.
Provide patients with an accurate comparison of coverage and out-of-pocket costs for traditional radiation therapy vs. Proton therapy.
Compile accurate patient estimates based on the ordered treatment modality, the patient’s insurance coverage, and any out-of-pocket thresholds.
Provide in-person and phone consultations for uninsured and underinsured patients regarding financial assistance options, payment arrangements, and external social service referrals, including Medicaid.
Obtain and review financial assistance applications and make hardship determinations based on current Federal Poverty Levels and established organizational policies.
Set up and manage payment arrangements on accounts, ensuring continuous follow-up and updates to reflect any changes in patient circumstances.
Properly document any actions taken and all account activity in Patient Management and Electronic Medical Record systems.
Works in a collaborative team environment to resolve patient inquiries and requests in a skillful and understanding manner.
Work collaboratively with the Proton Therapy Authorization Specialist to provide regular updates to patients on authorization status, especially during extended processing times.
Answer patient calls and requests promptly and efficiently.
Maintain patient confidentiality at all times in accordance with healthcare regulations.
Coordinate with front office, clinical, and patient accounting teams to ensure seamless scheduling and treatment integration.
Follows Tennessee Oncology Policy & Procedure parameters as outlined by management to ensure standardization of function.
Daily completion and follow-up of assigned tasks ensure no assistance is overlooked.
Stay informed on industry trends, insurance policy changes, and other factors that may impact patient financial situations.
Additional responsibilities as assigned to help drive our mission of improving the lives of everyone living with cancer.