As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, belonging, integrity, quality and trust that are integral to our mission. EO/AA

This position is responsible for informing and assisting patients with their financial obligations for oncology health care services, through education, insurance benefit confirmation, coverage enrollment assistance, financial hardship applications, or other funding programs. This position is not responsible for providing care to patients.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

• Perform Referral/Authorization verification to confirm secured services, or address authorization denials, and patient liability.
• Pre-screens patients and conducts early intervention to determine financial risk (i.e. job loss, change in social circumstance or other impacting factors).
• Conducts interviews and screenings for unfunded patients to determine all available funding source(s), including commercial insurance, government programs (Medicare, Medicaid), Affordable Care Act plans, University Cobra assistance program, referral to social security, and disability, or other programs/sources.
• Works with government agencies, third party payers, and other key parties to process applications, paperwork, or other requirements until completion and/or resolution.
• Assists uninsured patients with financial hardship applications. May grant full or partial charity, prompt pay discounts, or payment arrangements.
• Coordinate internal referral to Huntsman resources i.e. social workers, wellness clinic, or any additional services that would help reduce patient’s expenses outside of medical bills (i.e. housing, medications etc.).
• In collaboration with provider/clinic, produce cost comparison price estimates to determine the most cost effective treatment plan.
• Collaboration with case management and providers to address direct admissions and assist with transition of care due to lack of insurance coverage.
• Coordinates with patient for payment of estimated patient responsibility.
• May coordinate and obtain "Certificate of Medical Necessity" or other approval for scheduled services when patient is unable to make payment towards services.
• Coordinates communication with patients, families, providers or other key parties when authorization or benefits are not secured.
• Displays and understands the difference between individual and collective accountability; promotes cooperation and commitment to team goals.
• May perform other duties as assigned.

Knowledge / Skills / Abilities

• Knowledge of cancer resources and review patients for cancer programs, referral to cancer foundations.

• Demonstrated understanding of clinical treatment plans and corresponding clinical trials.

• Ability to coordinate and communicate with patients regarding treatment plan, insurance benefits, and financial questions, with empathy and compassion.

• Ability to express information in a clear and understandable manner.

• Demonstrated exceptional time management skills.

• Ability to resolve customer requests.

• Ability to take ownership for the quality and timeliness of work and achieve results with little oversight.

• Ability to solicit and act on constructive feedback, challenge oneself with tough assignments, and demonstrate resilience and courage in the face of setbacks and oppositions.

Qualifications

Required

• Three years of experience with medical accounts receivable, insurance claims, or equivalency.
• High School Diploma, or equivalency.

Preferred

• Health care financial counseling experience.
• Bilingual language skills may be preferred.
• Experience with the Medicaid enrollment process.
• Coding certifications.
• Knowledge of CPT, ICD10 and DRG codes.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.