FINANCIAL COUNSELOR - HOPD ONCOLOGY

GENERAL STATEMENT OF DUTIES:  This position demonstrates service excellence and positive interpersonal skills in dealing with others including patients, families, employees, medical staff to maximize communication and productivity. This position serves to educate patients regarding their insurance coverage and individual financial responsibility for cancer therapies.  Further, the position will provide patients access to financial resources available to them as well as assistance with the process.

PRIMARY JOB FUNCTIONS:

• Performs prior authorization process with all third-party payers relative to all radiology, injectable drug and testing.
• Identifying if authorization is needed, completing the paperwork if needed, and notifying others if not obtained prior to treatment.

• Properly documents financial authorization process including manuals, logs and monitoring and track request.
• At least 95% accuracy appropriately obtaining authorization.
• Ensures all insurance, demographic, and eligibility information is obtained and entered into the system in an accurate manner.

• Demonstrates an understanding for patient confidentiality to protect the patient and the practice.
• Follows policies and procedures to contribute to the efficiency of the front office.
• Covers for and assists with other billing office functions as requested.
• Positive written and verbal communication with Physicians, managers, and peers.

OTHER JOB FUNCTIONS: 

Duties performed in this position include but are not limited to the following:

• Greets customers in polite, prompt, helpful manner.  Provides any necessary instructions, directions, or explanations. 
• Responds in a courteous and timely manner to phone, mail and in-person inquires.  Answers patient questions, inquires and concerns regarding their accounts.  Reports patient satisfaction issues to supervisor.
• Documents all communications with patients in the computer billing system with a note or a task.
• Notify PSR for those that need insurance card information updated.
• Notify PSR if the patient needs to see the Financial Counselor.
• Maintains positive and open communications regarding problem resolution with patients, peers and other departments.
• Other projects and task as needed

TYPICAL PHYSICAL DEMANDS:  Work may require hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands or deliveries, or sitting or standing for extended periods of time.  Manual dexterity required for using a calculator, computer keyboard, telephone, Multi-function printers and other such office equipment as necessary.

TYPICAL WORKING CONDITIONS:  Normally eight hours per day – Monday through Friday, 8:00am to 4:30pm with a scheduled lunch every day.  The position may require paid overtime before and/or after normal working hours.  Personnel work in well lighted and well-ventilated office.  Personnel expected to adhere to general office policy.  This position will not be exposed to blood and body fluids.  Personnel will spend majority of day in front of computer terminal entering data, using telephone, faxes, copiers and printers.   Personnel are subject to frequent interruption.

PERFORMANCE REQUIREMENTS: Good organizational skills, knowledge of computer systems, ability to handle multiple responsibilities, detailed oriented, decision making and communications skills.  Ability to prioritize high volume work queue. Good team approach and positive attitude a must.

EDUCATION:  High school diploma or G.E.D.

EXPERIENCE:  Minimum of one year experience in customer service setting.  Insurance experience required preferably in Oncology practice.

HIPAA Compliance:  In order to fulfill the responsibilities of this position, access to the following information is required:  Billing/Medical Records.