Patient Finance Authorization Coordinator
General Summary
The Patient Finance Authorization Coordinator is responsible for all aspects of CHCWM’s patient financial policy which includes verifying insurance, authorizing chemotherapy treatment, estimating the cost of therapy and providing counseling to patients and family about covered services and financial responsibility, and collecting patient payments. Ensure the financial feasibility of treating each patient in our clinics by communicating and working closely with patients, physician, nurse and social worker and reimbursement team members.
CHC Team Philosophy
Must demonstrate ability to work with TEAMS. Must demonstrate positive attitude and can do spirit. Major focus must be on doing what’s best for our patients, physicians and staff. Must display honesty and integrity in every area of leading.
Job Requirements
Education: High School diploma with medical office/billing certificate or degree.
Experience: Two to four years’ experience in hospital or physician registration, insurance verification, medical billing office or nursing experience.
Other: Proficiency with medical terminology, both written and oral. Ability to review detailed data and make prompt judgments based on that data. Research and problem solving abilities. Ability to multi-task efficiently and effectively under tight deadlines, interruptions and high work volume. Excellent written and verbal communication skills. Strong organizational skills. Working knowledge of computers and their applications to the related field. Professional appearance.
Preferred Knowledge/Skills/Abilities/Education/Experience
Ability to competently use Microsoft Office, including Outlook, Work, Excel and appropriate practice management and electronic medical record software
Highly organized, able to take initiative to meet goals and work independently
Associates Degree in Business and / or Healthcare
Centricity Group Management experience
Primary Duties and Responsibilities (Essential Functions)
Review schedules in advance of appointment to ensure necessary insurance verification and authorization. Make updates to Group Management as required.
Accurately authorize and documents in patients EMR for chemotherapy treatment plans per insurance and diagnosis.
Responsible for preparing estimates of therapies to provide to patients.
Provide counseling to patients and their families by reviewing CHC financial policy, covered services, and estimated cost of therapy and patient’s financial responsibility. Refer appropriate patients to Social Workers for additional financial resources; assisting as necessary.
Work with patients and families to resolve account balance issues, including collection of patient due balances, setting up payment plans, etc.
Communicate with physicians, nursing, social work and other reimbursement team members promptly and professionally.
Maintain knowledge of payor, NCCN and FDA label guidelines, collection techniques and collection laws.
Function as a team member by expanding his/her responsibilities as directed by management to facilitate optimal workflow within the cancer center.
Communicates and interacts with peers and other departments in a manner that is viewed as having a positive effect on patient services and CHCWM staff morale. Interacts effectively with patients/family members and demonstrates sensitivity in regards to cultural diversity, age specific needs and confidentiality to HIPAA standards.
This employee has access to medical records daily. The parts of the medical record s/he needs to references to perform his/her job are as follows: Electronic Medical Record (ONCO EMR), Electronic Billing System (GPMS).
These functions are intended to describe the general nature, level and requirements of work being performed within this position. This job description may not be inclusive of all assigned duties, responsibilities, or aspects of the job described, and may be amended at any time at the sole discretion of the employer.
Work Environment
Able to access, input and retrieve information from computer. Very fast-paced and ever changing office environment. Demanding regarding deadlines and time frames. Very detailed and challenging work. Constant demand for updating knowledge. Able to see clearly in an environment which is equipped with typical lighting. Able to perform manual tasks that require the use of fine muscle motor skills. 80% of the time spent sitting, 20% spent walking/moving, able to transport items weighing less than 20 pounds and 5% of the time.