Financial Counselor

Essential Job Functions

• Plan, schedule, and maintain processes and performance to accomplish duties within time frames.
• Processes all Chemotherapy and Infusion Treatment Authorizations
• Works fax queue daily for new orders that require authorizations
• Ensures all orders are valid with name, DOB, physician signature, ICD-10 code
• Ensures all orders meet medical necessity
• Appeal letters as needed for denials
• Works closely with Patient Financial Services to review any claim of denials that have been authorized
• Provides the necessary patient information required to support claim process and denials
• Manage all specialty pharmacy scripts that require authorization
• Works with specialty pharmacy for setting up new scripts
• Fax scripts to specialty pharmacy for refills
• Works with patients on copay and out of pocket cost for specialty drugs
• Initiating mail order pharmacy enrollment
• Patient Assistance Programs
• Copay assistance
• Drug replacement programs
• Research available patient assistance programs
• Obtain patient financial information to support assistance programs
• Follow each patient on assistance programs and resubmit applications annually
• Contributes to and promotes positive relationships between physicians, hospital staff, guests and the local community
• Respects at all times the confidentiality of patient information
• Ensures compliance with confidentiality standards
• Promotes a positive relationship between staff, physicians, patients, and guests
• Meets with other hospital personnel, physicians, or patients to facilitate cooperation and resolve existing or potential conflicts
• Handles conflict with tact and courtesy
• Communicates effectively with patients in regard to financial information for treatment
• Follows up on issues or complaints
• Solves problems that may occur in the financial counseling area in a timely manner
• Participates in various hospital and community events
• Participates in the planning, development and implementation of annual department goals and objectives
• Reviews department's goals annually, providing input and assists in the development of personal and team goals and objectives to support the plan
• Adheres to Corporate Compliance Program
• Maintains and protects the confidentiality of all Protected Health Information

Education

• High School Diploma Required
• Associate's degree from two-year college preferred

Requirements

• 1-2 Years experience in billing or insurance preferred
• 1-2 Years Experience In Hospital Scheduling Preferred
• 1-2 Years experience in authorization and patient assistance preferred
• 2-3 Years experience in Oncology & Hematology authorization and patient assistance most preferred