Job: Oncology Clinic Financial Counselor Classification: Hourly/NonExempt Job Category: 5 Administrative Support Workers
Position Summary The Financial Counselor is responsible for performing financial clearance functions including but not limited to verifying insurance eligibility and benefits ensuring authorizations and providing price estimates. Need to be able to calculate patients expected financial portion of billed charges. This position facilitates resolution in disputed billing issues with patients. Serve as subject matter and provides support on special projects. This position will assume responsibility without constant direct supervision.
Essential Functions Responsible for direct patient interaction and contact regarding insurance eligibility and benefits review. Detailed knowledge of medical insurance benefits and access to TRMC resources regarding managed care contracts. Responsible for confirming patient insurance eligibility and providing benefits review. Responsible for obtaining insurance preauthorization or referral approval codes prior to each treatment. Verify eligibility and medical benefits with third party payers for scheduled services including but not limited to infusion treatment injections and chemotherapy. Price regimens and treatment orders to calculate patients responsibility. Generate a patient financial treatment estimate and counsel each patient prior to the start of each new regimen or treatment. Coordinate appointment times with front desk to allow for counseling time. Stays current on available financial aid that may be available for the patient. Responsible for coordinating care from a financial aspect with physicians clinical staff pharmacy and billing staff. Identify patients in need of financial assistance and inform them of all possible options. This will include financial assistance programs and working with any drug replacement programs. Assess patients ability to meet expenses and discusses payment arrangements. Communicate to the infusion nurses and treating physicians any delays in the financial counseling process including patients that are not cleared for treatment in a timely manner. Document all patient financial counseling activities and interactions in the patients electronic chart. Ability to add subtract multiply and divide in all units of measure using whole numbers common fractions and decimals. Adheres to and follows all patient experience initiatives. Reports to and depart from work on time and as scheduled. Performs other duties as assigned. Must be able to deal with stress while maintaining composure. Follows and adheres to TRMC vaccine policy(s) mandated by the Centers for Medicare & Medicaid Services (CMS).
Work Experience Billing experience and medical terminology preferred. Minimum two 2 years medical insurance experience or equivalent preferred. Knowledge of ICD9 and CPT codes preferred. Understanding of medical terminology preferred. Familiar with computers and knowledge of general clerical duties preferred.
Education High school graduate or equivalent preferred. Physical Demands and Work Environment Lifting/Carrying Pushing/Pulling Lbs. Time Lbs. Time
1 033 2 033 5 033 760 033
Movement Time Bend/Stoop/Twist 033 Crouch/Squat 033 Kneel/Crawl 033 Reach above Shoulder 033 Reach below Shoulder 033 Repetitive Arm None Repetitive Hand 3466 Grasping 033 Squeezing 033 Climb Stairs None Walking Uneven 033 Walking Even 3466
Environment Time Indoors 67100 Outdoors 033 Extreme Heat None Dusty None Excessive Noise 033
Equipment Time Motor Vehicles None Foot Pedals None Extreme Heat None Dusty None Excessive Noise 033
Work near Time Machinery None Electricity None Sharps None Chemicals None Fumes None Heights None
Vision Depth Perception Required < 20 Required Color Not required Peripheral required Endurance Hours at Once Total in 12HR Sit 4 8 Stand 1 2 Walk 1 2
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