Financial Services Advisor

2 weeks ago

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

Location:
American Oncology Network LLC

Compensation Range:
$31.56

Position Overview:


A Financial Counselor acts as the intermediary between patients and the healthcare practice, facilitating payment processes, assisting with financial aid, managing patient balances, and enhancing communication regarding financial obligations.

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

The Financial Counselor is responsible for maintaining up-to-date insurance benefits in the electronic medical records (EMR) and billing systems while confirming that patient services align with insurance coverage requirements.


Key Responsibilities:


1. Coordinate with insurance providers on pre-certification and prior authorization, including peer-to-peer discussions and appeals, while collaborating with the provider or pharmacy team as necessary.

2. Review patient schedules for upcoming appointments and treatments 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 for new treatment orders and discuss insurance benefits and financial responsibilities with patients.

5. Gather necessary information from patients for financial assistance eligibility.

6. Review patient aging balances and establish suitable arrangements to address outstanding amounts.

7. Explain necessary documentation such as waivers, treatment estimates, payment plans, and assistance applications to patients.


8. Maintain open communication with providers, nursing staff, and colleagues throughout the workday via Teams, phone, email, and in-person discussions regarding financial responsibilities and other relevant matters.


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


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


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


12. Comply with all applicable Federal and State laws and regulations regarding patient care, rights, safety, billing, and collections.

Overtime may be required with prior notice.

13. Maintain a tidy work area and orderly records.

14. Ensure all company equipment is safe and functional.

15. Adhere to all organizational and departmental policies and procedures, including those related to the revenue cycle.

16. Perform additional duties and projects as assigned.

Qualifications:

Education:
High school diploma or GED required.

Additional Education or Certifications:
Preferred further education or relevant certifications.

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

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

Excellent verbal and written communication skills are required.

Knowledge of insurance requirements, including familiarity with medical terminology, ICD9, ICD10, and CPT codes is necessary.

Experience in cash handling and collections is also required.

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

Core Competencies:

Analytical Skills:
Strong critical thinking abilities, including problem-solving, analysis, decision-making, planning, time management, and organizational skills. Attention to detail and independent judgment are crucial.

Interpersonal Skills:
Developed interpersonal abilities, emotional intelligence, diplomacy, tact, conflict resolution, delegation skills, and awareness of diversity. Capability to handle sensitive and confidential information, especially in emotionally charged situations.

Communication Skills:
Proficient command of the English language; a second language is an asset but not mandatory. Effective communication skills (oral, written, presentation), active listening, and the ability to provide constructive feedback are essential.

Customer Service Orientation:
Strong focus on customer service.

Ability to foster a culture of quality, performance effectiveness, and operational excellence through best practices, strong business acumen, collaboration, and positive relations with employees, physicians, and the community.


Self-Management:
Effectively manages time, conflicting priorities, stress, and professional growth. Self-motivated and capable of working independently with minimal supervision.


Must thrive in a fast-paced, multi-site environment with the ability to manage competing priorities and demands from various stakeholders.


Technical Skills:
Proficiency in MS Office applications (Word, Excel, PowerPoint, and Outlook) is required.

Ability to navigate multiple screens and applications to complete job functions efficiently.

Travel: 0%

Standard Work Schedule:
Monday to Friday, 8:00 AM to 5:00 PM. Occasional overtime and weekend shifts may be required based on operational needs.

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