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Financial Services Advisor

2 months ago

Honolulu, Hawaii, United States American Oncology Network LLC Full time
Location:
Honolulu Office
Pay Range:
$34.82

American Oncology Network LLC

Position Overview:

The Financial Counselor acts as a key intermediary between patients and the healthcare practice, facilitating payment processes, providing assistance, monitoring patient financial balances, and enhancing communication regarding financial obligations. This role is responsible for ensuring the accuracy of pre-certification and prior authorization processes. The Financial Counselor also maintains up-to-date insurance benefits in electronic medical records (EMR) and billing systems while confirming that patient services align with insurance coverage requirements.

Key Responsibilities:
  • Oversee and coordinate with insurance providers on pre-certification and prior authorization, including peer-to-peer reviews and appeals, collaborating with the provider or pharmacy team as necessary.
  • Examine patient and physician schedules for upcoming appointments and treatments to determine patient financial responsibilities.
  • Analyze treatment plans to verify active insurance coverage and communicate any discrepancies to the provider promptly.
  • Generate service estimates based on new treatment orders and discuss insurance benefits and patient responsibilities with patients.
  • Collect necessary information from patients to assess eligibility for financial assistance programs.
  • Review outstanding patient balances and establish payment arrangements to address any overdue amounts.
  • Guide patients through required forms and documentation, including waivers, treatment estimates, payment plans, and assistance applications.
  • Maintain open communication with providers, nursing staff, and other team members throughout the workday to discuss financial responsibilities and related matters.
  • Collaborate with external entities to ensure timely completion of necessary forms and documentation.
  • Assist patients in completing applications for financial aid and other grant-funded programs to secure support for treatments and services.
  • Possess knowledge of patient assistance programs and grant services to facilitate effective application and coordination with the financial aid counseling team.
  • Comply with all relevant Federal and State regulations regarding patient care, rights, safety, billing, and collections.
  • Maintain a tidy work environment and ensure all company equipment is functional and safe.
  • Adhere to all organizational policies and procedures, including those related to revenue cycle management.
  • Perform additional duties and projects as assigned.
Qualifications:

Education: High school diploma or GED required; further education or degrees are advantageous. Experience:
  • Minimum of two years of experience in the healthcare sector, ideally in a clinical or administrative setting.
  • Prior experience in healthcare customer service.
  • Familiarity with medical terminology and insurance verification processes.
  • Experience with pre-certification and prior authorization with medical insurance.
  • Strong verbal and communication skills are essential.
  • Knowledge of insurance requirements, including understanding medical terminology, ICD9, ICD10, and CPT codes.
  • Experience in cash handling and collections.
  • Ability to calculate patient responsibilities and insurance co-pays/coinsurance.
Core Competencies:
  • Analytical Skills: Strong problem-solving, analytical, and decision-making abilities with attention to detail.
  • Interpersonal Skills: Excellent interpersonal skills, emotional intelligence, and the ability to manage conflicts and diverse situations.
  • Communication Skills: Proficient in English, with effective oral and written communication skills.
  • Customer Service Orientation: A strong focus on customer service and the ability to foster positive relationships.
  • Self-Management: Ability to manage time effectively and prioritize tasks in a fast-paced environment.
  • Technical Skills: Proficient in MS Office applications, including Word, Excel, PowerPoint, and Outlook, with the ability to navigate multiple systems.
Travel: 0%

Standard Work Hours: Monday to Friday, 8:00 AM - 5:00 PM.