ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: Cancer Center Financial Advocate

REPORTS TO POSITION: Operations Manager

DEPARTMENT: Cancer Center

DATE LAST REVIEWED: July 22 , 2013

OUR VISION: Creating Americas healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENTAL SUMMARY:

The Cancer Center at St. Charles Health System is a comprehensive cancer center that provides holistic care to our patients. The cancer center provides chemotherapy, medical oncology, infusion services, radiation therapy, integrative medicine, nutrition, social work, survivorship and other supportive care treatments

All of our staff support our patients in the various stages of their treatments.

POSITION OVERVIEW:

The Cancer Center Financial Advocate at St. Charles Health System works with patients to assist them in understanding their financial responsibilities regarding treatment for hospital and professional services. This includes providing insurance verification, estimates, preauthorization, and assistance programs to best practice standards. Refers patient to other St. Charles Health System programs/departments as needed. Track and monitor services required throughout their course of care.

This position does not directly manage any other Caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

Verifies patient insurance eligibility and coverage. Establishes co-pay, deductible, and co-insurance amounts, deposits and max out of pocket in accordance with St. Charles Health System credit and collection guidelines.

Maintains working knowledge of Medicare, Medicaid, Commercial and HMO payors. Remains current on all insurance company changes/requirements applying authorization requirements.

Provides estimates of cost for Cancer Center procedures.

Obtains insurance preauthorization for services ordered by Cancer Center providers.

Awareness of CPT and ICD-9/10 as needed to provide/perform authorization services.

Identifies and assist eligible patients in applying for external and internal patient assistance programs, i.e. free drug, drug replacement and grant programs.

Refers patients to SCHC financial assistance programs as needed. Prrovide patients with applications for SCHC Financial Assistance Program when appropirate. Assists physician in completing Physician Attestation forms to facilitate application priority/determination.

Work with pharmacist and other staff to receive, document and inventory patient drugs received through assistance plans.

Assists with review, tracking and correction of denied claims.

Track, manage and coordinate patients financial services throughout treatment course.

Monitor and track financial impact of assistance programs.

Refers patients to St. Charles Health System programs as needed, including social work, nutrition, complimentary therapies, financial services, ACS programs.

Demonstrates skill in analytical problem solving and the ability to solve math problems with accuracy.

Knowledge of organizational structure, workflow, and operating procedures. May provide coverage for other department areas as needed.

Supports the vision, mission and values of the organization in all respects.

Supports Value Improvement Practice (VIP- Lean) principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the organizations corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient and accurate.

May perform additional duties of similar complexity within the organization, as required or assigned.

EDUCATION:

Required: High school diploma or GED.

Preferred: Two years of college or technical degree.

LICENSURE/CERTIFICATION/REGISTRATION:

Required: N/A

Preferred: N/A

EXPERIENCE:

Required: N/A

Preferred: Two years experience working in a hospital, clinic or medical insurance billing office. Customer services skills. Ability to triage and prioritize workflow. Experience with Mosaiq, Hospital EMR, Microsoft Office products, automated systems and computers.

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Must have excellent communication skills and ability to interact with a diverse population and professionally represent St. Charles Health System.

Ability to effectively interact and communicate with all levels within St. Charles Health System and external customers/clients/potential employees.

Strong team working and collaborative skills.

Ability to work under pressure in a fast-paced environment.

Ability to multi-task and work independently.

PHYSICAL REQUIREMENTS:

Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.

Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.

Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.

Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-25 pounds, operation of a motor vehicle.

Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors

Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category

No Risk for Exposure to BBP

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Schedule Weekly Hours:

Caregiver Type:

Shift:

Is Exempt Position?

Job Family:

Scheduled Days of the Week:

Shift Start & End Time:

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