Oncology Financial Coordinator

Job Summary and Qualifications

The Outpatient Oncology Financial Coordinator at TriStar Centennial Medical Center has a working knowledge of healthcare finances and insurance related to stem cell transplant and hematologic malignancy patients. This role involves working with providers, patients, donors, and caregivers to determine and facilitate access to healthcare benefits for treatment and/or stem cell transplant. The coordinator advises on available benefits and financial obligations, serves as a resource and liaison, and coordinates care options for under or uninsured patients.

What You Will Do in This Role

• Complete initial financial screening on all new/referred patients.
• Obtain, track, and update ongoing detailed patient/donor insurance benefit information and care authorizations for all aspects of the treatment plan.
• Discuss benefits and other financial issues with patients and caregivers; answer questions concerning insurance and other financial issues, advise patients on insurance benefit issues.
• Provide written copy of financial screening.
• Communicate/apprise program physicians and administration of any potential reimbursement issues prior to treatment being provided, work collaboratively with provider, insurer, and administration to resolve; obtain approval for treatment/transplant from internal executive committee for under or uninsured patients if needed.
• Counsel patients and providers regarding services that are related and unrelated to global contract periods and document patient/donor counseling sessions.
• Develop and track logs of required benefit data for all hematology malignancy/stem cell transplant patients.
• Absorb responsibility for assessment, communication, and tracking of patient financial requirements.
• Assist with obtaining prior authorization for drugs, procedures, and admissions as needed.
• Assist PharmD with preauthorization of discharge meds as needed.
• Obtain authorization for transplant medical evaluation, collection, and transplant admission.
• Maintain basic knowledge of the duties of the program revenue analyst to allow for coverage of key strategic needs in their absence.
• Participate in activities geared to attaining and keeping COE status with insurers including but not limited to RFI preparation, survey site visits, training, reporting, etc.
• Track and report gaps in needed vendors and facilities gap resolution.
• Adhere to FACT, COE, and other external regulatory agency standards, procedures / requirements.
• Serve as a liaison with other providers (i.e. case management, social work, transplant revenue analyst) in order to coordinate the completion of FMLA paperwork.
• Provide monthly financial reports regarding case mix index.
• Track the cause related to patients deciding to transplant elsewhere, especially those that decide to leave for another program late in the process.

Qualifications

• 3 years of experience in a physician front office/hospital patient access setting required.
• 3 years of experience with insurance procedures/terminology and patient interactions required.
• 3 years of experience obtaining authorizations/predeterminations required.
• PC skills – advanced knowledge of Microsoft Office, spreadsheets, financial reports required.
• Bachelor’s Degree preferred.

Benefits

TriStar Centennial Medical Center offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.

Note: Eligibility for benefits may vary by location.