PAS Financial Specialist

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At Banner MD Anderson, patients experience customized, comprehensive and compassionate cancer care. We travel through the cancer journey with patients, supporting their unique medical and personal needs every step of the way. We believe patient care is most effective when it’s truly collaborative. Our evidence-based, multidisciplinary approach brings together physicians from all cancer specialties to provide highly coordinated and compassionate care.

The PAS Financial Specialist is responsible for providing personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research for Oncology. This position partners with the clinical care team to determine financial impact for the patient and serves as the primary contact for any financial questions related to a patient’s care across the entire continuum of their treatment, ensuring a seamless experience for the patient and their family.  This role requires 3 years of experience working with insurances and payors as well as an Associate's Degree (or relevant experience). 

POSITION SUMMARY
This position is responsible for providing personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research for Oncology. This position partners with the clinical care team to determine financial impact for the patient and serves as the primary contact for any financial questions related to a patient’s care across the entire continuum of their treatment, ensuring a seamless experience for the patient and their family.

CORE FUNCTIONS
1. Performs pre-registration/registration processes. Partners with the clinical care team to determine initial authorizations needed based on the predicted care treatment plan. Obtains patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing, if necessary. Assesses need for alternative coverage sources.

2. Verifies insurance coverage and obtains authorizations and notifications throughout the patient’s treatment. Obtains all necessary signatures and documentation required by the patient’s insurance plan. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, preferred providers and changes in patient’s treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patient’s care and maximum reimbursement and minimized financial impact to the patient.

3. Provides financial counseling to patients and their families and serves as the primary resource throughout the patient’s treatment. Discusses benefits and other financial issues with patients and/or family members during initial referral and during continuation of care. Advises patients on insurance and billing issues and options. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients, families and team members in addressing insurance coverage gaps via alternative funding options.

4. Provides financial advocacy, assistance and support to patients and families, as needed. Assists patients who are un-insured to access other funding resources and completes required documents. Maintains current working knowledge of Medicare, Medicaid and other program benefits and criteria, particularly as they pertain to long-term care and low-income patients. May serve as a liaison between the facility and community in making community resources available to the patient and family.

5. Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence.

6. Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments.

7. May provide leadership and training to other members of the financial team and serves as a resource for internal and external customers.

8. Works independently under general supervision, leads and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. This position is an integral part of the care team, as they serve as the primary contact for all financial aspects of the patient’s care, both for internal and external customers. Internal customers include all levels of the clinical care team, as well as other administrative support positions throughout the facility and organization. External customers include patients and their families, physician office staff and third-party payors.

MINIMUM QUALIFICATIONS

EEO/Disabled/Veterans

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