Location: Oncology Consultants - Business Office Pay Range: $19.66 - $34.59

Position Summary:

Responsible to assist in the organization and implementation of all aspects related to Financial Counseling. Act as team lead for assigned staff including Trainers, Floats, and newly acquired Revenue Cycle staff. Act as a resource person for all office staff and patients in resolving financial counseling issues. Performs the daily tasks of Financial Counselor and acts as Float and/or Trainer as necessary in any assigned Company office.

Key Performance Areas:

• Assist Manager with organizing all aspects related to Financial Counseling duties for clinics.
• Act as team lead to assist immediate supervisor with training, monitoring work and addressing workflow concerns.
• Expected to travel locally.
• Assist with interviewing and hiring potential managed care staff including clerks.
• Provide support to all staff with Financial Counseling questions.
• Maintain ability to work the desk as Financial Counselor as necessary to cover vacations and/or position vacancies.
• Assist in developing/writing and maintaining the department Standard Operating Procedures.
• Work with Clinic Financial Manager to organize staffing and training for all locations; maintain up-to-date staffing calendars and distribute to team as needed
• Assist with the timecard management of assigned site staff, including ensuring compliance with Company attendance policy, monitoring/tracking overtime, and arranging coverage for time off requests as delegated by Clinic Financial Manager.
• Assist Clinic Financial manager with reviewing and approving patient payment plans.
• Make recommendations for improvement in processes and display ability to develop and implement improvement plan as needed in the department.
• Assist CFM in developing quarterly work reviews and annual performance reviews for financial counselors.
• Take a lead role in updating and maintaining financial counseling training materials.
• Monitor daily/weekly schedules to identify and review all HMO, Medicaid, Self Pay accounts according to the policies and procedures established in the Managed Care training manual. Report all areas of concern to FC Merger Supervisor.
• Develop a daily accounts receivable report that will be handed out to the front office staff detailing the amount of money to collect from each patient.
• Meet with new patients upon first office visit as needed. Confirm demographic information; explain insurance benefits to patient, detailing their financial responsibility, obtain necessary consent form signatures, including HIPAA policy. Input changes and other pertinent information obtained into the computer.
• Identify patients not paying according to their treatment plan or with ongoing account balances and make arrangements to meet with them prior to their visit.
• Identify patients that are having first time chemotherapy and will have a financial responsibility, complete an estimate of service form to go over with the patient.
• Meet with those patients prior to them receiving their first chemotherapy treatment. Explain what their financial responsibility will be and determine a method of payment for the patient.
• Request authorizations as required for internal services as well as outside tests, hospital admittance and referrals to doctors. Document all information in Onco/EMR and Centricity.
• OncoEMR offices: Review managed care report continuously for drug approvals.
• Drug approval requests should be handled as quickly as possible. The financial counselor must review all treat regimes for diagnosis appropriateness based on the clinic policy or accepted compendia of the patient’s insurance. The financial counselor will also determine if prior authorization is required and request the authorization if needed. Request approval on special order drugs from Clinic Financial Manager. Meet with physician if drug is determined to be a non-covered medication.
• Explain and have patient sign waivers when new drugs are given without the proper billing codes, as well as off label for diagnosis or lab values.
• Register patients that will be receiving newly approved FDA drugs with appropriate “Hot Line” to support reimbursement if insurance carrier refuses treatment or payment.
• Verify eligibility of Medicaid patients and keep practice management information system updated for any changes.
• Update Onco/EMR and Centricity for any insurance changes made. Verify benefits input into system. For those patients with charts, make sure to change the chart label.
• Keep the demographic screens and insurance benefits updated continuously in Onco/EMR and Centricity.
• Work closely with nurses, doctors, patient service specialists and office managers to collect co-pays, coinsurance, and resolve any insurance and self-pay issues.
• Work closely with the Clinic Financial Manager to ensure that patient financial obligations are being met, self-pay patients are properly handled, and necessary drugs are approved before being ordered.
• Assist patients in completing the patient assistance application and any other forms that the Company requires the patient to complete.
• Make use of the patient assistance program for under-insured patients.
• Maintain and ensure the confidentiality of all patient and employee information at all times.
• Will be expected to work overtime when given sufficient notice of required overtime.
• Keep work area and records in a neat and orderly manner.
• Maintain all company equipment in a safe and working order.
• Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, and collections. Adhere to all Company and departmental policies and procedures, including IT policies and procedures and Disaster Recovery Plan.

Position Qualifications:

Education

• High School Diploma or GED.
• Experience working in a healthcare field (preferably in a clinical setting or business office) is required.
• Excellent verbal and communication skills needed.
• Insurance knowledge requirements include understanding of medical terminology, managed care authorization process, ICD and CPT codes, collection experience and ability to calculate and collect patients’ responsibility and insurance co-pay/coinsurance.

​Skills

• Ability to effectively communicate and interact with coworkers, insurance company staff, hospital staff, patients, public, physicians and their staff.

Travel

• 0-25%