Job Description The Business Office is responsible for onboarding all new patients into the Medical Oncology & Hematology and/or Radiation Oncology departments. Under direction of the Financial Services Supervisor and BCC Operations Manager, the Financial Services Coordinator performs specific functions requiring specialized education or training, such as oncology coding (ICD-9, CPT, HCPCS), knowledge of NCCN guidelines for drug therapy indications payable by insurers or Medicare/Medicaid, and patient advocacy/drug replacement programs which enhance or replace charity care provided by the institution.
Performs team's processes with respect to patients with inability to pay; i.e. serves as liaison between patient, MOH and Finance, submitting applications for Medicaid, FAP, grants, etc., and determines eligibility for any Federal, State or internal Stamford Health System assistance programs. Provides assistance to all patients of the Medical Oncology & Hematology and/or Radiation Oncology Departments, from pre-registration to collection of funds. He/she evaluates patient insurance and counsels patients on financial matters including benefits, financial support, drug assistance and other assistance programs. Handles inquiries from customers regarding any aspect of services received or status of account, and applies outstanding customer service skills on a daily basis. Has functional knowledge of patient access and billing operations in the specialized field of medical oncology and hematology.
Responsibilities 1. Demonstrates knowledge of the revenue cycle.
2. Performs follow up of claims. Maintains files and contacts appropriate parties to determine correct status and follow up of unpaid accounts. Processes and follows up on all assigned patient accounts until paid in full, managing accounts receivable for professional service billing.
3. Updates receivable system with any new, corrected or pertinent information in relation to resolution of receivable accounts, and insures that proper information for follow up is shown in both GE and Meditech.
4. Understands and accurately applies requirements for pre-certification of chemotherapy drug regimens; pre-certifies treatments as indicated by government and private insurers.
5. Insures eligibility and benefits are properly verified prior to initial visit and thereafter as directed.
6. Makes daily deposits. Balances credit card machines and other deposit reconciliations as required.
5. Pre-registers patients. Demonstrates ability to have meaningful discussion of benefits with patient when pre-registering in Meditech and GE Centricity, and when present in the department.
6. Performs patient financial counseling. Evaluates care plans and communicates with patient to establish payment expectations based on individual insurance benefit plans.
7. Is able to learn quickly and demonstrate proficiency with various software programs, including Meditech and GE Centricity as required.
8. Assists physicians in determining approved regimens for treatment. Familiar with NCCN guidelines and insures that regimens are approved according to same.
9. Demonstrates knowledgeable of coding for ICD-10, CPT and HCPCS.
10. Applies department processes for non-profit, community, pharmaceutical, federal, state and health system financial assistance programs. Demonstrates knowledge of Federal and State requirements for assistance for patients with inability to pay.
11. Demonstrates knowledge of drug replacement programs, grant programs, co-pay foundation programs and other cancer-related patient support options. Processes and monitors applications for same, and captures highest level of value to patient and institution. Maintains cumulative value record of same.
12. Provides timely and accurate information regarding patient data/status to other health system departments, physicians, physician office staffs, and other public agencies while insuring patient confidentiality is not breached.
13. Exhibits excellent customer service skills and serves as an advocate for the patient in obtaining and understanding all assistance programs.
14. Performs other related duties as assigned or requested in order to maintain a high level of service.
Qualifications - Demonstrates a high degree of honesty, integrity and accountability.
- Is self-disciplined & organized, and able to complete work and monitor accounts with minimal daily supervision.
- Completes required continuous training and education, including department specific requirements.
- Demonstrates professional work behavior at all times by following Service Standards and Success factors.
- Demonstrates strong interpersonal and verbal/ written communication skills.
- Complies with departmental organizational policies and procedures and adheres to external agency requirements.
- Bilingual preferred but not required.
- High School diploma or equivalent required, some college or business school training preferred.
- Five (5) or more years prior equivalent experience in a business setting is preferred.
- A high degree of computer literacy in a PC environment is required, including Microsoft office products. Previous EMR / PM system experience preferred.
*We are committed to building an inclusive workplace that values diversity and inclusion and reflects the diversity of the community and patients we serve.