Financial Coordinator Oncology

Job Description

The Oncology Financial Coordinator is responsible for obtaining accurate financial approvals for patients at Intermountain Health. The Oncology Financial Coordinator is responsible for analyzing and validating the information needed to obtain financial approval for services. This position mitigates the financial risk to Intermountain Health by performing an accurate financial review along with a comprehensive analysis of patient payer specific benefits and patient liability and provides a platform for counseling patients on financial considerations throughout their care experience.

This position works with a multidisciplinary team consisting of patients, revenue cycle, physicians, nurses, and pharmacists. Posting Specifics Benefits Eligible: Yes Shift Details: Shifts will be between Monday - Friday 8:30am to 5pm Unit/Department: Oncology Essential Functions Verify the prescriber is currently credentialed with the facility or through Select Health, or verifies the prescriber has an active license in good standing. Ensure clinically appropriate documentation is received timely from medical providers/facilities, and ensures medical necessity is appropriate for type of services being provided.

Evaluate the need for, and if appropriate, confirms Letter of Medical Necessity has been received to ensure third party payment. Ensure orders include an appropriate ICD-10 code. Collaborate with clinicians and intake managers to minimize risk associated with medical necessity or financial sponsorship changes that affect the reimbursement. Make appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement.

Obtain insurance eligibility and benefit information, ensures authorization requirements are completed within the required timeframe, and maintains appropriate authorizations throughout patient treatment at the specified clinic. Ensure ongoing eligibility based on clinical documentation for medical necessity and ensure reauthorization functions are completed in a timely manner, based on individual payer requirements. Estimate cost of service using ICD-10 or CPT codes. Performs calculations using insurance benefit information to accurately estimate patient responsibility. Analyzes patient/guarantor's previous account history to guide financial conversation.

Educate patient regarding Medicare ABN and potential costs associated with non-coverage, as well as ramifications of not signing the form. Sends the Medicare ABN to the patient if necessary. Communicates the ABN status to the specific Infusion Clinic. Skills Healthcare Common Procedure Coding System (HCPCS) ICD Coding Medical Billing and Coding Medical Insurance Coding Medical Billing Medical Records Management Coding Education Coding Practices Clinical Documentation Health Administration Minimum Qualifications Experience as a Financial/Eligibility Counselor, Health insurance related experience (billing…

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