Financial Advocate

Pay range: $21.86 - $29.52 hourly, varies on experience.
Medical Oncology - Remote/Hybrid Bend, Oregon

Relief Differential: 15%

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE:                                      Cancer Center Financial Advocate

REPORTS TO POSITION:        Operations Manager

DEPARTMENT:                         Cancer Center

DATE LAST REVIEWED:          July 22 , 2013

OUR VISION:                Creating America’s healthiest community, together

OUR MISSION:             In the spirit of love and compassion, better health, better care, better value

OUR VALUES:              Accountability, Caring and Teamwork

DEPARTMENTAL SUMMARY:

The Cancer Center at St. Charles Health System is a comprehensive cancer center that provides holistic care to our patients.  The cancer center provides chemotherapy, medical oncology, infusion services, radiation therapy, integrative medicine, nutrition, social work, survivorship and other supportive care treatments

All of our staff support our patients in the various stages of their treatments. 

POSITION OVERVIEW:

The Cancer Center Financial Advocate at St. Charles Health System works with patients to assist them in understanding their  financial responsibilities regarding treatment for  hospital and professional services.  This includes providing insurance verification, estimates,  preauthorization, and assistance programs to best practice standards.  Refers patient to other St. Charles Health System programs/departments as needed.  Track and monitor services required throughout their course of care.

This position does not directly manage any other Caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

Verifies patient insurance eligibility and coverage. Establishes co-pay, deductible, and co-insurance amounts, deposits  and max out of pocket in accordance with St. Charles Health System credit and collection guidelines.

Maintains working knowledge of Medicare, Medicaid, Commercial and HMO payors.  Remains current on all insurance company changes/requirements applying authorization requirements.

Provides estimates of cost for Cancer Center procedures. 

Obtains insurance preauthorization for services ordered by Cancer Center providers.

Awareness of CPT and ICD-9/10 as needed to provide/perform authorization services.

Identifies and assist eligible patients in applying for external and internal patient assistance programs, i.e. free drug, drug replacement and grant programs.

Refers patients to SCHC financial assistance programs as needed.  Prrovide patients with applications for SCHC Financial Assistance Program when appropirate. Assists physician in completing Physician Attestation forms to facilitate application priority/determination.

Work with pharmacist and other staff to receive, document and inventory patient drugs received through assistance plans.

Assists with review, tracking and correction of denied claims. 

Track, manage and coordinate patients financial services throughout treatment course. 

Monitor and track financial impact of assistance programs.

Refers patients to St. Charles Health System programs as needed,  including social work, nutrition, complimentary therapies, financial services, ACS programs.

  

Demonstrates skill in analytical problem solving and the ability to solve math problems with accuracy.

Knowledge of organizational structure, workflow, and operating procedures.   May provide coverage for other department areas as needed. 

Supports the vision, mission and values of the org