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Healthcare Financial Consultant

2 months ago

Memphis, Tennessee, United States Baptist Memorial Healthcare Corporation Full time
Position Overview

The Financial Counseling Specialist plays a crucial role in ensuring that patients receiving chemotherapy and other essential medical services are aware of their financial obligations and that these services are justified according to insurance policies and medical guidelines. This position is responsible for initiating and managing pre-certifications and prior authorizations in accordance with payer requirements before any treatment is administered. The specialist also provides guidance to patients regarding their financial responsibilities, assists in enrolling them in financial assistance programs, and acts as a liaison with the Patient Assistance Team. Responsibilities include collecting payments, managing payment plans, and performing additional duties as required.

Key Responsibilities
  • Review and assess treatment plans for medical necessity and compliance with insurance policies and medical guidelines.
  • Conduct research on insurance policies and medical literature to verify service eligibility.
  • Analyze patient medical records to gather necessary information for pre-certification processes.
  • Ensure timely tracking and management of authorizations from various insurance carriers.
  • Educate new patients about their insurance benefits and anticipated out-of-pocket costs prior to treatment.
  • Collaborate with patients and their families to collect required payments and establish payment plans.
  • Gather necessary consent forms and financial documentation to facilitate applications for assistance programs.
  • Support self-pay patients in applying for financial assistance programs.
  • Work closely with healthcare providers to ensure positive patient outcomes and timely access to treatment.
  • Maintain compliance with regulatory requirements and communicate necessary guidelines to relevant staff.
  • Perform additional tasks as assigned.
Qualifications and Experience

Education

Preferred: Associate's degree or completion of two years of college coursework.

Minimum: Strong communication skills in English, both written and verbal, with the ability to document information accurately.

Experience

Preferred: Five years of experience in a healthcare setting, with a focus on front-end collections.

Minimum: Three years of office experience, including at least one year in a healthcare environment.

Licensure and Certification

Preferred: CHAA certification.

Skills

Preferred: Familiarity with oncology pre-certification standards and guidelines.

Minimum: Ability to interpret medical policies and guidelines. Proficient in multitasking, basic computer operations, and problem-solving. Capable of managing challenging situations with patients and families.

About Baptist Memorial Healthcare Corporation

Baptist Memorial Healthcare Corporation is committed to the well-being of our patients and the community. Our team is dedicated to providing exceptional care and support, backed by competitive compensation and benefits. We value our employees and strive to create a rewarding work environment that promotes professional growth and development.