Financial Counselor, Oncology Job Type: Full-time

The Oncology Financial Counselor supports patients during this challenging time, helping to reduce the financial burden throughout the continuum of their care. The Oncology Financial Counselor helps evaluate insurance benefits and discuss with patients their responsibility and programs available toassistwith high co-pays or out of pocket amounts. The Oncology Financial Counselor obtains all authorizations for treatment and ensures criteria has been met and isaccurate. They will help patients understand insurance benefits and obligations andassistpatientwith completing important paperwork forassistanceprograms if applicable. The Oncology Financial Counselor also coordinates with the business office inassistingwith resolving claim issues and denials.

Core competencies include, but are not limited to the following:

Plan,scheduleandmaintainprocesses and performance toaccomplishduties withintimeframes. 1. Processes all Chemotherapy and Infusion Treatment Authorizations. 1. Works faxquedaily for new orders that require authorizations. 1. Ensures all orders are valid with name, DOB, physician signature, ICD-10code. 1. Ensure all orders meet medicalnecessity

Appeal letters as needed for denials 1. Works closely with Patient Financial Services to review any claim denials that havebeenauthorized. 1. Provides the necessary patient informationrequiredto support claim process &denials.

Manage all specialty pharmacy scripts that requireauthorization 1. Workwithspecialtypharmacy for setting up newscripts. 1. Fax scripts to specialty pharmacy forrefills. 1. Works with patients on copay and out of pocket cost for specialtydrugs. 1. Initiating mail order pharmacyenrollment

Patient AssistancePrograms. 1. Copayassistance. 1. Drug replacementprograms. 1. Research available patientassistanceprograms. 1. Obtain patient financial information to supportassistanceprograms. 1. Follow each patient onassistanceprograms and resubmit applications annually

Contribute to and promote positive relationships between physicians, hospital staff,guestsand the localcommunity. * Respectsat all times the confidentiality of patient information. Ensure compliancetoconfidentialitystandards. * Promotesa positive relationship between staff, physicians,patientsandguests. * Meetswith other hospital personnel,physiciansor patients tofacilitatecooperation and resolve existing or potential conflicts. Handles conflict with tact andcourtesy. * Communicates effectively with patientsin regard tofinancial information for treatment. * Follows up on issues or complaints.Resolveproblems that may occur in the financial counseling area in a timely manner. * Participates in various hospital and community events.

Participates in the planning,developmentand implementation of annual department goals andobjectives * Reviewsdepartment’s goals annually, providing input andassistsin the development of personal and team goals andobjectivesto support the plan. * Adheres to Corporate ComplianceProgram. * Responsible formaintainingand protecting the confidentiality of all Protected HealthInformation. * All other duties as assigned.

Minimum EducationAssociate's Degree in Medical Billing, Coding, Insurance, Healthcare Administration, or other related health science:X Preferred □ Required

Minimum Work Experience1-2 Years experience in billing or insuranceX Preferred □ Required1-2 Years experience in hospital schedulingX Preferred □ Required1-2 Years experience in authorization and patient assistanceX Preferred □ Required2-3 Years experience in Oncology & Hematology authorization and patient assistanceX Preferred □ Required

Required SkillsRequires critical thinking skills, decisive judgment and the ability to work under the supervision of Registered Nurse. Must be able to work in a stressful environment and take appropriate action.

Job: *Accounting/Finance

Organization: *Starr Regional Medical Center

Title: *Financial Counselor - Oncology *

Location: Tennessee-Athens

Requisition ID: 7412-6938