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Financial Counselor

Winchester, Kentucky

Req ID 301663 Post Date Apr. 17, 2025 CategoryPeople Services FacilityGeorgetown Community Hospital
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Full time

Benefit eligible

Located Clark Regional Medical Center

Clark Regional Medical Center

Who We Are:

People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Clark Regional Medical Center is a 79 bed community hospital featuring updated technology including new and expanded services such as Diagnostic Services, larger capacity Emergency Services, home-like Labor and Delivery Suites, and a skilled nursing facility. The campus also includes a 45,000 square foot Medical Plaza housing the Clark Clinic, Diagnostic Center for Women, Center for Rehabilitation, Specialty Clinic and Anticoagulation Clinic.

Where We Are:

Winchester offers a truly original experience to all with so much to do and see. Just a short drive from Lexington, the “Horse Capital of the World,” and the Red River Gorge, you can experience all the beauty and excitement nature has to offer. 

Why Choose Us:

  • Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
  • Competitive Paid Time Off
  • Employee Assistance Program – mental, physical, and financial wellness assistance
  • Tuition Reimbursement/Assistance for qualified applicants
  • Membership discounts with local gyms and community businesses
  • Free Parking
  • And much more…

Summary:

The Oncology Financial Navigator / Oncology Financial Counselor supports patients during this challenging time, helping to reduce the financial burden throughout the continuum of their care.  The Oncology Financial Navigator helps evaluate insurance benefits and discuss with patients their responsibility and programs available to assist with high co-pays or out of pocket amounts.  The Oncology Financial Navigator obtains all authorizations for treatment, help patients understand insurance benefits and obligations, and assist patient with completing important paperwork for assistance programs if applicable.  The Oncology Financial Navigator also coordinates with the business office in assisting with resolving claim issues and denials. 

Essential Job Function:

  1. Plan, schedule and maintain processes and performance to accomplish duties within time frames.
    1. Processes all Chemotherapy and Infusion Treatment Authorizations
      1. Works fax queue daily for new orders that require authorizations
      2. Ensures all orders are valid with name, DOB, physician signature, ICD-10 code
      3. Ensure all orders meet medical necessity 
    2. Works closely with Lung Program Coordinator Lung Cancer Screening Orders.
    3. Appeal letters as needed for denials
      1. Works closely with Patient Financial Services to review any claim denials that have been authorized.
    4. Manage all specialty pharmacy scripts that require authorization
      1. Work with specialty pharmacy for setting up new scripts 
      2. Fax scripts to specialty pharmacy for refills
      3. Works with patients on copay and out of pocket cost for specialty drugs 
      4. Initiating mail order pharmacy enrollment.
    5. Patient Assistance Programs
      1. Copay assistance
      2. Drug replacement programs
      3. Research available patient assistance programs
      4. Obtain patient financial information to support assistance programs
      5. Follow each patient on assistance programs and resubmit applications annually
  2. Contribute to and promote positive relationships between physicians, hospital staff, guests and the local community.
    1. Respects at all times the confidentiality of patient information. Ensure compliance to confidentiality standards.
    2. Promotes a positive relationship between staff, physicians, patients and guests.
    3. Meets with other hospital personnel, physicians or patients to facilitate cooperation and resolve existing or potential conflicts.  Handles conflict with tact and courtesy.
    4. Communicates effectively with patients in regard to financial information for treatment.
    5. Follows up on issues or complaints.  Resolves problems that may occur in the financial counseling area in a timely manner. 
    6. Participates in various hospital and community events.
  3. Participates in the planning, development and implementation of annual department goals and objectives
    1. Reviews department’s goals annually, providing input and assists in the development of personal and team goals and objectives to support the plan.
  4. Adheres to Corporate Compliance Program
  5. Responsible for maintaining and protecting the confidentiality of all Protected Health Information. 
  6. All other duties as assigned. 

Minimum Qualifications:

  • High School Diploma Required 
  • Associate's degree from two-year college preferred 

Requirements

  • 1-2 Years experience in hospital scheduling preferred 
  • 1-2 Years experience in authorization and patient assistance preferred
  • 2-3 Years experience in Oncology & Hematology Authorization and Patient Assistance preferred

EEOC Statement:

Clark Regional Medical Center is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.

We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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