TCHP Financial Advocate Associate - Mason Medical Oncology - Full Time - Days

Job Description

The financial advocate provides financial counseling services through direct consultation with patients face to face and over the phone. Responsible for understanding the patient’s financial standing, determining a financial course of action based on that standing and seeking financial assistance as appropriate for each patient. Understands the coordination of insurance benefits, screens for any type of assistance and assists in the application process for programs for assistance such as co pay cards, charity organizations and drug replacement. Possess the ability to estimate patient liability based on treatment plans / pre-certification and deliver estimation to the patient and their family. Senses emotionally sensitive financial situations and mitigates family and patient burden; works continuously with patients and family to adjust financial programs and payment plans as needed during and after the treatment process. All activities will be preformed in support of the strategy, vision and values of TCHHN. Nothing in this job description restricts the managements right to assign or reassign duties or responsibilities to this job at any time. All activities must be in compliance with equal employment opportunity laws, HIPAA, ERISA and other regulations as appropriate.

Responsibilities

Obtains accurate patient demographics and insurance information to be used for billing and reimbursement purposes

Educates Patients about their rights and insurance benefits, including how much of the annual deductible has been paid and the difference between co payments and coinsurance, and any benefit caps in place. The advocate will explain the total cost of the planned treatment, the patients out of pocket expense and the practice payment policy. They will also be available to explain HIPAA, advance directives, Waivers, and advanced beneficiary notices.

Conducts financial screening of uninsured / underinsured patients to gather pertinent information to determine potential program eligibility, this will include working with the financial counselors to get patients enrolled with state and federal programs.

Utilizes communication skills to obtain necessary information while conveying sensitivity to patient and family

Collects funds for co-insurance, co pays and deductible

Uses experience and knowledge as well as various tools to determine which assistance programs will have the greatest benefit for the patient (Drug manufacturer copay cards, foundation grants, charities, or drug replacement)

The financial Advocate obtains information and applications for patients and assists in filing them with or for the patient for each assistive program.

The advocate will be responsible for maintaining a detailed spreadsheet of all patient assistance information as well as documenting all contact correspondence and verifications for future reference by the manager and any departments that require this data. This includes documenting in the patients electronic record.

Discusses High balance accounts with patients and discusses and determines payment arrangements and / or if any other financial assistance is available.

Maintains close contact with patients and families to satisfy concerns and questions. Schedule one on one appointments to review the financial assistance process and review and adjust payment plans as needed.

Monitors pending applications and drug replacement to ensure timely processing for the patient and the practice.

Consults with Program and Billing Manager on difficult cases.

Attends Staff meetings, completes mandatory in-service requirements and competency evaluations on time. Maintains the latest knowledge about financial advocacy in the Hematology and Oncology arena.

Preforms other duties as assigned and completes all job functions as per departmental and hospital policy.

Preforms all job duties and responsibilities in alignment with the core values, mission and vision of the organization.

Qualifications

KNOWLEDGE AND SKILLS (e.g. BSN required, MSN preferred.) :

Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.

EDUCATION : High School diploma required. Two year degree in a related field preferred.

YEARS OF EXPERIENCE : No experience required. One to two years of case management or billing experience preferred.

REQUIRED SKILLS AND KNOWLEDGE :

Compassionate and patient

Organized, detail oriented

Knowledge of Microsoft Excel and use of spread sheets

Good listener

Analytical and independent worker

Persevering

Enjoys personal interaction with patients

Open to learning about Oncology / Hematology Care

Open to learning billing procedures

Open to learning different insurance plans

Willing to maintain knowledge in present areas of responsibility.

LICENSES REGISTRATIONS & / or CERTIFICATIONS :