Description
The Oncology Financial Coordinator is responsible for obtaining accurate financial approvals for patients at Intermountain Health.
This role involves analysing and validating information to obtain financial approval for services, mitigating financial risk, and providing a platform for counselling patients on financial considerations throughout their care experience.
The Oncology Financial Coordinator works with a multidisciplinary team consisting of patients, revenue cycle, physicians, nurses, and pharmacists.
Essential Functions
- Verify the prescriber is currently credentialed with the facility or through Select Health, or verifies the prescriber has an active license in good standing.
- Ensure clinically appropriate documentation is received timely from medical providers/facilities, and ensures medical necessity is appropriate for type of services being provided.
- Evaluate the need for, and if appropriate, confirms Letter of Medical Necessity has been received to ensure third-party payment.
- Ensure orders include an appropriate ICD-10 code.
- Collaborate with clinicians and intake managers to minimise risk associated with medical necessity or financial sponsorship changes that affect the reimbursement.
- Make appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement.
- Obtain insurance eligibility and benefit information, ensures authorisation requirements are completed within the required timeframe, and maintains appropriate authorisations throughout patient treatment at the specified clinic.
- Estimate cost of service using ICD-10 or CPT codes.
- Educate patient regarding Medicare ABN and potential costs associated with non-coverage, as well as ramifications of not signing the form.
Benefits
- Benefits eligible
- Monday - Friday 8:30am to 5:00pm, one day per week at home after training
Requirements
- Experience as a Financial/Eligibility Counsellor, Health insurance-related experience (billing, authorisations, etc.), or Certificate in healthcare coding.
- Demonstrated customer service experience in a healthcare, insurance, or financial field.
- Demonstrated organisational skills.
- Demonstrated self-starter and team-oriented, flexibility to adapt to change, ability to work with minimal supervision.
Preferred Qualifications
- Bachelor's degree in a healthcare field or business
- Bi-lingual
- Communication skills, both written and verbal