Responsibilities:
- Develops standard operating procedures to guide and build a program that effectively supports the care and financial responsibility of patients.
- Implements new processes to guide patients to the appropriate resources and support services.
- Meets new patients to the Institute, promoting available programs and services.
- Educates patients on availability of Patient Assistance Programs.
- Identifies, evaluates, and resolves cancer patient complaints.
- Assesses eligibility and assists self-pay and under insured patients with Patient Assistance Programs (PAP) for free drug, replacement drug and copay assistance.
- Coordinates with clinical team and social workers in identifying eligible patients as well as obtaining information and documentation for eligible patients.
- Interviews potential patients for assistance and collects all financial forms related to eligible PAP application and maintains data base.
- Monitors and tracks status of application and communicates with pharmacy, physician and clinical team.
- Clarifies patient medications and dosages and generates applications for PAP renewals.
- Forwards adjustment requests to Revenue Cycle Management for assisted patients when applicable.
- Educates staff and Administration to assist in understanding of processes and procedures surrounding PAP's and encourage patient referrals.
- Tracks and monitors data analytics and database related to all new patients being treated at Taussig cancer Center, main campus and region , and their contractual arrangements for cancer services and out of pocket responsibilities.
- Captures data queries that will drive decisions and process improvement for treatment delivery as well as collaboration with payers.
- Obtains authorizations for research and non-FDA approved procedures and treatments; submits letter of Medical necessity and follow-up for approvals on procedures.
- Other duties as assigned.
Education:
- Associate's degree in Finance, Business or other related field.
- Bachelor's degree preferred.
- Additional progressively responsible experience may offset degree requirement.
Certifications:
- None required.
Complexity of Work:
- Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
- Must be able to take appropriate action in a stressful environment.
Work Experience:
- Minimum three years of related experience in a health care environment or medical office setting with diverse, patient/culture populations, exhibiting problem solving skills.
- Attentions to detail and accuracy.
- Excellent interpersonal skills, process improvement and problem resolution.
- Computer experience and ability to navigate multiple systems simultaneously.
- Knowledge of insurance coverage, limitations, requirements, eligibility, pharmacy formulary, prior authorization, coordination of benefits, diagnosis codes, billing and collecting.
- Requires strong communication, analytical and critical thinking skills.
- Ability to work with supervision.
Personal Protective Equipment:
- Follows Standard Precautions using personal protective equipment as required.
Pay Range
Minimum hourly: $18.88
Maximum hourly: $28.80
The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic’s benefits package, which includes among other benefits, healthcare/dental/vision and retirement.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System’s Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.