About the position
The Cellular Therapy Finance Specialist is responsible for the front-end verification of patients' transplant, CAR-T, and leukemia service benefits from intake to throughput. The finance specialist understands unique payer contracts, self-pay agreements, patient registration, precertification, authorization process, and maintains accuracy in coding and billing to ensure timely reimbursement. The finance specialist interacts directly with payers to secure insurance authorization for patient transplant, CAR-T, and leukemia medical services to safeguard reimbursement and minimize patient and organization financial risk. The finance specialist works collaboratively with cellular therapy clinical team, patient intake and transplant coordinators, quality, finance, and revenue cycle to help provide financial decision support for clinical operations and to positively impact the revenue cycle. The Cellular Therapy Finance Specialists will participate in meetings relevant to the position, collaborate with the Cellular Therapy Program Quality, Regulatory and Compliance team to establish performance metrics, track cellular therapy financial performance, and report on key performance measures/indicators to the Cellular Therapy Program leadership team and Cellular Therapy Program Quality Assurance and Improvement Committee.
Responsibilities
- Verifies 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.
- Provides financial counseling to patients and their families specific to their stem cell transplant, CAR-T, leukemia benefits, and self-pay agreements.
- Works in alignment with the cellular therapy intake and transplant coordinators to obtain authorizations and ensure timeliness of patient schedules and care.
- Obtains all necessary signatures and documentation required by the patient's insurance plan.
- Maintains current working knowledge of Medicare, Medicaid, Commercial payor and other program benefits and criteria.
- Monitors and updates information regarding insurance data, authorizations, preferred providers, and changes in patient's treatment plan.
- Act as a resource to patient accounting stakeholders. Review and problem solve insurance claim denials.
- Utilize and maintain current knowledge of patient account management techniques and information systems.
- Maintains accurate statistical, contractual, and financial databases related to stem cell transplant and CAR-T programs.
- Under the direction of the Director of Quality, Regulatory and Compliance to develop and implement key performance metrics.
Requirements
- Minimum 3 years in related field
- High school diploma or GED
- Working knowledge of medical and hematology/oncology terminology
- Annual Stem Cell Transplant & CAR-T training
Nice-to-haves
- More than 3 years in stem cell transplant experience
- Associates Degree
- Working knowledge of stem cell transplant, CAR-T, and malignant hematology terminology
- Annual Stem Cell Transplant & CAR-T training
