Financial Services Advisor

2 weeks ago

Naples, Florida, United States American Oncology Network LLC Full time

Location:
American Oncology Network LLC

Compensation:
$31.56 per hour

Position Overview:


A Financial Counselor acts as the essential link between patients and the healthcare practice, facilitating payment processes, providing assistance, managing patient balances, and enhancing communication regarding financial obligations.

This role includes overseeing the quality control for pre-certification and prior authorization.

The Financial Counselor is responsible for ensuring that patients' insurance benefits are accurately recorded in the electronic medical records (EMR) and billing systems while confirming that the services provided align with insurance coverage criteria.


Key Responsibilities:


1. Monitor and coordinate with insurance companies regarding pre-certification and prior authorization processes, including peer-to-peer reviews and appeals, seeking assistance from the provider or pharmacy team when necessary.

2. Review patient schedules and upcoming treatment appointments to determine financial responsibilities.


3. Analyze treatment plans to verify active insurance coverage and patient financial obligations, promptly communicating any unexpected issues to the provider.


4. Generate service estimates based on new treatment orders and discuss insurance benefits and financial responsibilities with patients.

5. Collect necessary information from patients to assess eligibility for financial assistance programs.

6. Review patient aging balances and establish appropriate payment arrangements for outstanding debts.

7. Explain necessary forms and documentation, including waivers, treatment estimates, payment plans, and assistance applications.


8. Maintain open communication with providers, nursing staff, and colleagues through various channels to discuss financial responsibilities and related matters.


9. Collaborate with external entities to ensure timely completion of required forms and documentation.


10. Assist patients in completing paperwork for financial assistance and grant-funded programs to secure funding for treatments and services.


11. Understand patient assistance programs and grant processes to ensure effective application and coordination with the financial aid counseling team.


12. Comply with all relevant Federal and State regulations concerning patient care, rights, billing, and collections.


13. Maintain a tidy work environment and ensure all company equipment is in safe working order.


14. Adhere to all company policies and procedures, including those related to the revenue cycle.


15. Perform additional duties and projects as assigned.


Qualifications:

Education:
High school diploma or GED required.

Additional education or certifications are a plus.

Experience:
A minimum of two years of experience in the healthcare sector, preferably in a clinical or administrative setting.

Experience in healthcare customer service, medical terminology, insurance verification, and pre-certification processes is essential.

Strong verbal and written communication skills are necessary.

Knowledge of insurance requirements, including medical terminology, ICD9, ICD10, and CPT codes, is required.

Experience in cash handling and collections is preferred.

Ability to calculate patient responsibilities and insurance co-pays/coinsurance.

Core Competencies:

Analytical Skills:
Strong problem-solving, analytical, decision-making, planning, time management, and organizational skills. Attention to detail and the ability to exercise independent judgment are essential.

Interpersonal Skills:
Developed interpersonal skills, emotional intelligence, and the ability to manage conflicts and work with diverse populations.

Communication Skills:
Proficient in English; additional languages are an asset. Effective communication skills, including active listening and providing constructive feedback, are required.

Customer Service Orientation:
Strong focus on customer service and the ability to foster a culture of quality and operational excellence.

Self-Management:
Ability to manage time effectively, prioritize tasks, and work independently with minimal supervision.

Technical Skills:
Proficiency in MS Office applications, including Word, Excel, PowerPoint, and Outlook. Ability to navigate multiple software applications efficiently.

Work Schedule:
Standard work hours are Monday to Friday, 8:00 AM to 5:00 PM, with occasional overtime and weekend shifts as needed.

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