New Patient Coordinator Financial Counselor

Essential Functions

• a - Guide patient through the appointment process, including expectations of the first appointment.
• b - Coordinate/obtain clinical documentation prior to the first visit, including medical records and reports from all prior applicable appointments, pathology slides, and/or radiology films.
• c - Understand the process of care and schedule appropriately for all clinical diagnoses. Consult with clinical staff as appropriate to determine urgency of first appointment for palliative or urgent cases.
• d - Knowledgeable of financial arrangements, insurance coverage, and billing procedures.
• e - Schedule appointments in Epic/Aria capturing demographic, insurance and disease information.
• f - Identify self-pay or high risk financial patients; coordinate financial counseling as necessary (self-pay, non-participating insurance coverage, potential high coinsurance).
• g - Mail or electronically send “new patient packets” to patients.
• h - Add referrals to referral tracking form and send appropriate end of day and weekly wrap up emails.
• i - Upload imaging CDs.
• j - Work closely with nursing and therapy to determine scheduling logistics including financial clearance, status board submission and scheduling of simulation for urgent patients.
• k - Facilitate prior authorization for appointments as needed.
• l - Confirm all consultation appointments with patients via phone and answer any questions they may have

New Patient Care Coordination

• a - Carry out departmental quality assurance checks (e.g. consult notes) to ensure patient charts, documentation and care are complete and accurate.
• b - Facilitate patient care process following consultation by ensuring that physicians enter status board request for simulation and treatment in a timely manner.
• c - Monitor status board for approved cases and facilitate the scheduling of simulation. Ensure information from status board is transcribed into the patient simulation appointment.
• d - Confirm all simulation appointments with patients via phone, provide appropriate appointment prep information and answer any questions they may have.

Financial Intake and Counseling

• a - Works directly with identified new patients or directed established patients to obtain accurate demographic and financial information from self-pay and high financial risk patients.
• b - Utilize real-time automated tools for insurance verification, eligibility, and benefits information; may require contacting insurance carrier.
• c - Communicate with insurance carriers, study team, and/or other providers to obtain required information on the patient’s behalf.
• d - Compile and submit all necessary documents and data to support request for coverage of charges for services to be performed at DFCI.
• e - Communicate, as needed, with patients and/or their families to obtain financial information and/or address account concerns.
• f - Work with DFCI Patient Access and LROC billing to obtain financial clearance.
• g - Document all patient account correspondence in the appropriate note field, designated forms, or databases; this includes all incoming and outgoing telephone calls, referral number data, and any other account knowledge that becomes available.
• h - Pursue coverage opportunities for uninsured and underinsured patients; assist patients and families in the completion of financial assistance applications.
• i - Responsible for daily identification of problem accounts and handles resolution.
• j - Obtain same day insurance authorizations and referrals (services requested after 3:00 the previous day).
• k - Coordinate support with LROC billing and DFCI Patient Access to manage patient pre authorizations and referrals.
• m - Coordinate support for patients with financial issues including, but not limited to, investigating patients accounts and assisting patients/families and/or physicians with appeals for services in the event of a denied claim.

Confidentiality

• a - Regular exposure to patient demographic, diagnostic, and billing information.
• b - Exposure to physician information including physician numbers assigned by governmental agencies and insurance carriers.
• c - Institute contract information with third party payers.
• d - Institute financial information.

Job Requirements

• Minimum Education - Preferred High school diploma/GED preferred. Associates Degree Or Equivalent Experience Preferred.
• Minimum Work Experience - Preferred Prior Hospital/physician Office Registration/billing Experience Preferred.
• Minimum of 2 years of financial experience in a hospital or ambulatory setting preferred.
• Oncology Experience Preferred.
• Required additional Knowledge, and Abilities - Knowledge of managed care policies and medical terminology preferred. Working knowledge of Epic or other hospital/EMR systems Strong understanding of Microsoft Office product suite. Excellent customer service and communication skills, both written and verbal. Self-starter with strong team player and leadership abilities. Strong analytical, problem solving skills, mathematical/accounting skills. Ability to prioritize and meet pre-determined deadlines. Advanced technical skills, as appropriate. Flexible hours required.