Oncology Financial Navigator

Job Description

The Oncology Financial Coordinator is responsible for obtaining accurate financial approvals for patients at Intermountain Health.

The Oncology Financial Coordinator is responsible for analyzing and validating the information needed to obtain financial approval for services.

This position mitigates the financial risk to Intermountain Health by performing an accurate financial review along with a comprehensive analysis of patient payer specific benefits and patient liability and provides a platform for counseling patients on financial considerations throughout their care experience.

This position works with a multidisciplinary team consisting of patients, revenue cycle, physicians, nurses, and pharmacists.

Verifies the prescriber is currently credentialed with the facility or through Select Health, or verifies the prescriber has an active license in good standing and ensures medical necessity is appropriate for type of services being provided.

Providers / facilities, ensures clinically appropriate documentation is received timely from medical

• Evaluates the need for, and if appropriate, confirms Letter of Medical Necessity has been received to ensure third party payment.
• Ensures orders include an appropriate ICD-10 code.
• Collaborates with clinicians and intake managers to minimize risk associated with medical necessity or financial sponsorship changes that affect the reimbursement.

Makes appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and / or problems with billing and reimbursement.

• Returns form to physician if all requirements are not completed on the prescription form and educates physician regarding need.
• Obtains insurance eligibility and benefit information, ensures authorization requirements are completed within the required timeframe, and maintains appropriate authorizations throughout patient treatment at the specified clinic.

Ensures ongoing eligibility based on clinical documentation for medical necessity and ensures reauthorization functions are completed in a timely manner, based on individual payer requirements.

• Uses resources available to find any additional financial assistance for patients.
• Ensures proper documentation of financial assistance procured for each patient.
• Estimates cost of service using ICD-10 or CPT codes. Performs calculations using insurance benefit information to accurately estimate patient responsibility.

Analyzes patient / guarantor's previous account history to guide financial conversation.

• Communicates with patients the resources that have been established and the patient's obligation that remains.
• Educates patient regarding Medicare ABN and potential costs associated with non-coverage, as well as ramifications of not signing the form.

Sends the Medicare ABN to the patient if necessary. Communicates the ABN status to the specific Infusion Clinic.

• May lead and / or train new employees in account preparation and review functions.
• Maintains a satisfactory level of performance and adherence to workload standards.
• Understands and is compliant to all state and federal laws, regulations, policies and procedures, and guidelines related to the specific area of practice.
• Consistently demonstrates excellent customer service skills including problem solving, telephone etiquette, and responsiveness to customers.

Provides superior customer service that is consistent with policies, company values, and quality standards.

Minimum Qualifications

Experience as a Financial / Eligibility Counselor, - OR - Health insurance related experience (billing, authorizations, etc.

OR Certificate in healthcare coding

• Customer service experience in a healthcare, insurance, or financial field.
• Demonstrated outstanding public relations and interpersonal skills.
• Demonstrated organizational skills. Multi-tasker with demonstrated ability to complete work timely and accurately.
• Demonstrated self-starter and team oriented, flexibility to adapt to change, ability to work with minimal supervision.

Preferred Qualifications

• Bachelor's degree in a health care field or business.
• Bi-lingual (Spanish)
• Communication skills, both written and verbal
• Demonstrated knowledge of CPT / ICD 10 codes
• Medical terminology

Physical Requirements :

• Interact with others requiring the employee to communicate information.
• Operate computers and other office equipment requiring the ability to move fingers and hands.
• See and read computer monitors and documents.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

Anticipated job posting close date :

09 / 10 / 2024

Location :

Intermountain Health Alta View Hospital

Work City : Sandy

Sandy

Work State : Utah

Utah

Scheduled Weekly Hours :

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$ - $

We care about your well-being mind, body, and spirit which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado, Montana, and Kansas based caregivers;

and our commitment todiversity, equity, and inclusion.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.