Posted: Thursday, August 24, 2017 1:42 AM
Employment Status:AF : Active : Regular : Full Time
Job Summary 13;
The Financial Liaison acts as a centralized resource for families to gain support and education regarding the anticipated out of pocket costs of a new cancer diagnosis. They also serve as an expert on insurance verifications and authorizations when necessary for care coordination. They provide financial counseling to patients, families, and to the providers delivering care. The liaison works closely with in:patient and out:patient clinical staff, Patient/Family Education Specialist, PSRs, Research Coordinators, Insurance Specialists, Schedulers, and Social Workers from the point of the initial referral and throughout the treatment continuum. The liaison maintains and develops positive relationships and clear lines of communication with insurance representatives from multiple insurance companies who can provide precertification/authorization guidelines unique to the individual insurance plan. Works with health insurance providers to determine coverage, benefit limits, and financial responsibility and conveys this information to the clinical team, patient, and family. Networks with peers at other Centers, and internal precertification/insurance employees across CHOPs billing entities to stay abreast of and share recent changes, updates, and processes. Acts as a liaison between CHOP billing entities and oncology patients. Provides complete information to the Single Case Agreement Team on initial request, to facilitate a standardized process for non:par insurance plans rate negotiations. Strong communication skills, attention to detail, and a high level of organization are critical qualities. Possesses a high level of customer service and commitment to providing customer service excellence partnering with the children and families we serve.
Job Responsibilities 13;
1) Counsels, Educates, and Coordinates with families regarding insurance coverage plans.
:Obtains detailed patient insurance benefit information for all aspects of the treatment process from point of initial referral.
:After initial contact with patient/family, the liaison partners with Insurance Specialists to obtain authorizations.
:The liaison works closely with the family to schedule initial appointments once authorized.
:Partners with Social Worker and Patient Navigator to connect families to available resources to assist with financial obligations/ hardship; and processing applications for free care, special pharmacy benefits, etc.
:Prepares analysis of insurance plan, capitation information, co:pays, and deductibles and reviews anticipated out of pocket expenses with families. Assesses financial impact on families and collaborates with Patient Navigator and Social Worker to seek available resources. Informs clinical staff about coverage information, such as capitations and limited authorizations.
:Interacts with every patient and/or family who has a new cancer diagnosis (in person within 30 days of diagnosis). Ensures that communication is ongoing so that changes in coverage can result in updated review.
:Participates in new patient/ family education process partnering with the Patient/Family Education Specialist and Nurse Navigators.
:Partners with patients, their families, and team members to address insurance coverage gaps via alternative funding sources.
:Acts as central contact for families who have billing questions; facilitates resolution of issues.
:Communicates with family and/or guarantor, as necessary, to inform them of any insurance problems or restrictions, ensuring that insurance information is clearly relayed to and understood by family and/or guarantor.
:Respond to all emails and answers all telephone calls promptly
:Provides comprehensive explanations of covered and non:covered services
:Contacts appropriate clinical staff in timely manner with all information that requires follow:up.
• Location: South Jersey
• Post ID: 42888808 southjersey