Patient Financial Counselor

Location US-MA-Brookline
Job Posted Date 2 weeks ago(2/9/2018 9:57 AM)
Job ID
2018-9672
Category
Finance/Accounting/Patient Billing
Type
full time
Grade
19

Overview

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

The Patient Financial Counselor is responsible for promptly assisting patients with complicated insurance coverage issues, obtain access to services at the Dana-Farber Cancer Institute (DFCI) and its partner facilities, prior to their scheduled visit.  They are also responsible for explaining available payer programs and benefits to customers, including Mass Health, the Health Insurance Marketplace, COBRA or any other possible third party payer resource.  In addition, the Patient Financial Counselor is responsible for assisting patients apply for financial assistance programs including HSN Medical Hardship, the DFCI Patient Financial Assistance program and Drug Assistance programs. The Patient Financial Counselor prepares self-pay estimates for domestic and international patients, collects deposits and payments, creates payment arrangements, issues ABN’s and Waivers for cancer care services at the Dana-Farber Cancer Institute. The Patient Financial Counselor reports directly to the Supervisor of Access Management.

Responsibilities

  • Access the Financial Counselor Appointment Report and contacts patient insurance plans to request approval for services at Dana Farber Cancer Institute and our partner facilities. Contacts patients regarding the status of the insurance approval. Updates and completes registration information in the Hospital Information System. 
  • Complies and submits medical documentation requested by the insurance plan to support the approval for services at Dana Farber Cancer Institute and our partner facilities.
  • Professionally and effectively communicates with the clinical team the status of the insurance approval request.  Coordinates with patient/provider in appealing denied services, including coordinating peer to peer conferences.
  • Prepares Financial Waivers, Advanced Beneficiary Notices (ABN) and Drug Assistance applications for patients with insurance plans that may not cover services at Dana Farber Cancer Institute and the patient wants to proceed with care.  Accurately explains the details of the Waiver/ABN or Drug Assistance and obtains patient signature on the Waiver/ABN/Drug Assistance application.  
  • Screens self-pay patients for eligibility for state and payer programs. Assists in the application process for Massachusetts Medicaid and HSN Medical Hardship, the collection of required documents and submits the application on behalf of the patient.  Updates or completes registration information in the Hospital Information system.
  • Screens self-pay patients’ ineligible for any state or payer sponsored programs for eligibility for financial assistance programs including HSN Medical Hardship and the DFCI Financial Assistance Program. Assists in the application process, the collection of required documents and submits the application on behalf of the patient.  Updates or completes registration information in the Hospital Information system.
  • Prepares self-pay estimates, accurately explains the details of the estimate to the patient and obtains patient signature on the estimate.  Collects the required deposit.
  • Provides walk-in services to patients looking to make a co-pay, deductible or other payment type on their account or for assistance with selecting an insurance plan accepted at Dana Farber Cancer Institute and our partner facilities.
  • Verifies insurance eligibility and benefits utilizing real-time automated tools, payer websites and/or calls insurance carriers as necessary.
  • Documents all patient account correspondence in the appropriate note field, designated forms, or databases; This includes all phone calls incoming and outgoing, referral/authorization number data, and any other account knowledge that becomes available.
  • Completes assigned work queues, projects, and other duties as directed.

Qualifications

  • High school Diploma/GED required, Associates degree or relevant post-secondary education highly preferred.
  • Minimum of 2 years of hospital registration/billing experience required.
  • Knowledge of managed care policies and medical terminology preferred.
  • Working knowledge of Epic or other hospital/professional services billing systems preferred.
  • Strong understanding of Microsoft Office product suite.



Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.

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