Patient Financial Advocate

Job Description

Job Description

Description:

Join Our Compassionate and Dedicated Team at Cancer Care Associates of York!

Are you looking for a rewarding career in patient advocacy? Join a team of Oncologists and Hematologists at Cancer Care Associates of York who take pride in delivering personalized, professional, and compassionate care.

We are seeking a full-time Patient Financial Advocate.

The Patient Financial Advocate is responsible for delivering clear and accurate information to a patient regarding their insurance coverage, the cost of treatment, and financial obligations. Serves as a patient advocate by seeking financial resources and alternative funding that may be available for the patient.

JOB DUTIES: The following duties are considered essential for the Patient Financial Advocate. Qualified individuals must have the ability – with or without reasonable accommodation – to perform the following duties:

• Discusses with the patient the estimated costs of therapies as well as the practice’s financial policies.
• Reviews with the patient their insurance coverage including deductibles, co-insurance, co-pays and out-of-pocket max.
• Seeks financial resources and alternative funding available for appropriate patients such as copay foundations, copay cards; performs financial screening for indigent programs prior to the start of treatment; manages the processes of keeping all these functions flowing with renewals, updates, etc.
• Provides resources to patients with social and economic needs.
• Provides information to the patient regarding insurance coverage options and open enrollment choices.
• Assists the patient with enrollment in Pennie and Medicaid.
• Meets with the patient if there is a change in insurance coverage, employment status, or financial resources.
• Identifies EOM (Enhancing Oncology Model) patients via reports; then reviews with each EOM patient the total cost of treatment, insurance liability and patient liability. Explains to the EOM patient the EOM program and screens the patient for any social economic needs.
• Calculates total cost of treatment for EOM patients for a 6-month episode and records in the Patient Care Plan.
• Bi-monthly review of all patients being treated off-site, verifies current coverage of those patients, and notifies billing management of any updates. Maintains the off-site patient list.
• Verifies insurance benefits, as needed.
• Performs all billing for copay programs and foundations.
• Post all payments from copay programs and foundations; completes monthly reviews of all A/R, and performs appropriate follow-up to unpaid claims.
• Maintains regular and punctual attendance.
• Complies with all practice policies and procedures including CCAY’s Code of Conduct.

Education, Certification, and Licensure:

• A High School diploma or equivalent.
• Associates degree in social work or a healthcare related field, preferred or equivalent experience.

Essential job-related experience:

• Minimum two (2) years of experience in social work or a healthcare related field.
• Knowledge of medical and insurance terminology including Medicaid and Medicare.
• Knowledge of the implications of the effect of illness, and /or disability on patients and their families.
• Ability to verify insurance coverage quotes and understand and calculate reimbursement percentages.
• In-depth knowledge of insurance requirements needed, forms, and understanding of our network payers, secondary networks, non-local, and national insurances.

Preferred job-related experience:

• In-depth knowledge of financial counseling process, and patient assistance programs.
• Certified Applicant with Pennie.
• Experience with DHS and Medicaid Enrollment Process.
• Experience using Navinet and Availity.

Job-related skills:

• Strong written and verbal communication skills to communicate with patients, caregivers, and insurance plan representatives.
• Proficient in the use of personal computer operation including Microsoft Windows, Microsoft Word, and Excel.
• Good organizational skills and ability to understand detailed information.
• Ability to maintain empathy and professionalism during all patient interactions.
• Ability to multi-task & prioritize responsibilities
• Ability to work in a fast paced, demanding environment
• Ability to concentrate and work under pressure with time constraints
• Ability to work independently

Benefits:

• Competitive Pay
• Generous Paid Time Off & Paid Holidays
• 401(K) & Profit Sharing Plan w/ company contribution
• Affordable Medical, Dental and Vision Plans - eligible 1st of the following month after date of hire
• Life Insurance Plan - company paid
• Employee Assistance Program
• Voluntary Short & Long-Term Disability Plans
• Consistent Day Schedule w/ no weekends, evenings or holidays