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Role Description

The Patient Financial Advocate (PFA) serves as a key member of the Roper Saint Francis Cancer Center and serves as a conduit between patients and health care providers as they directly assist with the coordination of necessary services and connection to resources, including financial, both within and outside of the Roper Saint Francis Healthcare system.

• Provides assistance in the identification and removal of any financial barriers to treatment.
• Independently determines the acquisition cost/reimbursement ratio of requested therapy to ensure fiscal responsibilities and requirements of the infusion center are met.
• Utilizes independent judgement in reviewing and validating supporting documentation to ensure medical necessity of requested therapy is met.
• Collaborates with referring practices to correct deficiencies.
• If unable to approve requested therapy due to lack of supporting documentation, collaborates with the Medical Director for final determination and communication to requesting provider.
• Responsible for addressing and resolving billing, coding and/or reimbursement issues with Patient Financial Services and Reimbursement Services.

Qualifications

• High school diploma or equivalent (GED).
• At least 3 years of experience in healthcare billing, coding, or insurance required.
• Work experience involving CPT coding and ICD-10 coding is highly preferred.
• Experience dealing with prior authorization and the review process of insurance company highly preferred.

Requirements

• Knowledge of policies, procedures and guidelines of National, State and Local agencies providing financial sponsorship to patients including but not limited to commercial and governmental payors, National grant funding programs and pharmaceutical medication programs.
• Efficient data entry skills including ability to use spreadsheets.
• Excellent organizational skills and the ability to effectively handle multiple priorities and deadlines.
• Strong math skills.
• Excellent verbal/written communication and interpersonal skills to effectively deal with customers and staff.
• Ability to diplomatically and respectfully deal with customers both in person.
• Ability to maintain the confidentiality of sensitive information.

Benefits

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible).
• Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts.
• Paid time off, parental and FMLA leave, and short- and long-term disability.
• Tuition assistance, professional development and continuing education support.
• Benefits may vary based on the market and employment status.