Cancer Insurance Specialist

• Collects and verifies demographic information, insurance coverage, plan benefits, and referring physician data for (cancer) patients. Uses all necessary and available electronic systems and tools.
• Discusses in-person (preferred), or telephonically, benefits and financial information with all referred (cancer) patients and their families prior to initial evaluation. Provides face-to-face or telephonic financial counseling and information regarding the insurance to patients, families, and related Hospital staff.
• Obtains detailed patient insurance benefit information from point of initial referral, including initial consult, diagnostic work-up, hospitalization(s), and follow-up clinic visits.
• Collaborates with Social Worker and/or Pharmacy to provide information to patients and their families regarding available financial assistance resources. Assists patients in completing necessary documents to apply for financial assistance, free care, special pharmacy benefits, etc.
• Assists patients in answering billing questions and facilitates resolution of issues.
• Communicates/Educate family and/or responsible party, 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 responsible party.
• Completes abbreviated assessment to determine family eligibility for Charity Care programs, for handoff to Revenue Cycle’s approvals team (located offsite in Darien office).
• Communicates and coordinates as necessary with Patient Access team to share information and reduce redundancy.
• Initiates appropriate handoffs to other insurance specialists and departments, as patient moves from one clinical service, to another, to ensue continuous monitoring of benefits and obligations, while communicating same among colleagues.
• Communicates initially with Call Center regarding intake information, and then proactively and directly with the clinical team , regarding status of authorization and the need for clinical documentation
• Monitors and updates information regarding insurance data, physicians, authorizations, and preferred providers.
• Obtains all necessary payor authorizations for cancer care. Verifies coverage and other medical benefits and acquires necessary referrals and authorizations. Confirms pre- authorizations for procedures. Verifies receipt of and facilitates managed care referrals for office visits. Documents insurance coverage and authorization information in EPIC.
• Documents all relevant information into EPIC
• Partners with Single Case Agreement Department to facilitate non-par cases to obtain care/treatment.
• Responds to incoming calls regarding account status from patients and insurance companies.

• Bachelor’s degree, or equivalent, and/or 2 years’ experience working in medical insurance verification and./or other healthcare finance areas.
• Minimum of five years related healthcare registration, billing and/or reimbursement experience
• Advanced insurance authorization and registration techniques
• Previous experience in complex clinical setting that required coordination of multiple services
• Resource scheduling experience preferred (e.g. ancillary testing)
• Background in medical terminology; (Oncology) experience preferred
• Website Insurance Training (Navinet, WebMD, Passport)
• EPIC training & testing (Prelude/Cadence).
• Registration Essentials
• Windows-based PC experience
• Ability to schedule and register patients rapidly and accurately.
• Strong communication skills and must be able to communicate courteously and effectively with physicians, payors, and staff.
• Must be a self-motivated
• Individual must be highly organized and dependable, and able to work with minimum of supervision
• Ability to prioritize and work on several projects at once while maintaining communication with all invested parties.
• Ability to complete multiple tasks and work under pressure and in stressful situations
• Ability to quickly learn new procedures.

Position Details:

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days- 8:00am-5:00pm M-F
• Unit/Department: Revenue Cycle-Admitting
• Location when required to come to office: Hyde Park - Uchicago Main Campus
• CBA Code: Non-Union

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