Oncology Financial Coordinator

Job Description

Job Description

At Mahaska Health the Oncology Financial Coordinator serves as a financial advocate and resource for patients receiving oncology and hematology services. This role is responsible for assisting patients in understanding the financial aspects of their care, verifying insurance coverage, confirming prior authorizations are in place, coordinating financial assistance resources, and ensuring accurate reimbursement for oncology services. The coordinator works collaboratively with physicians, nursing staff, pharmacy personnel, revenue cycle teams, and external agencies to minimize financial barriers to treatment and support a positive patient experience.

Essential job responsibilities include but are not limited to,

Insurance Verification and Authorization

• Meet with patients and families to explain insurance benefits, financial responsibilities, and estimated treatment costs.
• Provide education regarding deductibles, co-pays, co-insurance, out-of-pocket maximums, and coverage limitations.
• Conduct financial assessments and discuss available payment options; to include presumptive Medicaid eligibility if appropriate
• Maintain sensitivity and professionalism when discussing financial matters with patients undergoing treatment.
• Verify insurance eligibility and benefits for oncology services, treatments, medications, and procedures.
• Track authorization approvals, denials, and expirations to ensure uninterrupted patient care.

Financial Assistance Coordination

• Identify patients eligible for financial assistance programs, grants, co-pay assistance, foundation support, and manufacturer-sponsored programs.
• Assist patients in completing applications and gathering required documentation.
• Coordinate with charitable organizations, pharmaceutical assistance programs, and internal financial assistance resources.
• Monitor application status and ensure timely renewals when applicable.

Revenue Cycle Support

• Collaborate with billing and coding teams to resolve claim issues and reimbursement concerns.
• Research and address insurance denials related to oncology treatments and services.
• Ensure accurate documentation supports reimbursement requirements.
• Maintain records related to financial counseling, authorizations, and assistance programs.

Patient Advocacy

• Serve as a liaison between patients, providers, insurers, and external agencies.
• Help patients navigate complex insurance and reimbursement processes.
• Advocate for reduced financial burden and access to medically necessary treatment.
• Escalate complex cases as needed to leadership, case management, or revenue cycle management teams.

Compliance and Documentation

• Ensure compliance with payer requirements, federal regulations, and financial assistance guidelines.
• Participate in audits, quality improvement initiatives, and departmental reporting activities.

Additional Responsibilities

• Collaboration with oncology providers, clinical staff, patient access teams, and business office personnel to ensure accurate financial coordination and reimbursement processes.
• A high degree of organization, confidentiality, critical thinking, and attention to detail while handling sensitive patient, financial, and insurance information in compliance with applicable privacy regulations.
• Frequent verbal and written communication to explain financial responsibilities, insurance coverage, payment options, and authorization requirements to patients and internal stakeholders.

Job Requirements include but are not limited to,

• High school diploma or GED equivalent required.
• Minimum of 2-3 years of experience in healthcare financial counseling with oncology administration preferred.
• Experience working with oncology, infusion, radiation oncology, or specialty pharmacy services preferred.
• Knowledge of Medicare, Medicaid, commercial insurance, and managed care plans.
• PC proficiency, experience with IP and OP hospital insurance claims filing and reimbursement principles desired.
• Must be able to use and operate office equipment.
• Skills should include organizational development, personnel management, budget and resource development, and strategic planning; demonstrated success developing and monitoring systems to manage both operational and programmatic work that involve high levels of collaboration.
• Adhere to all confidentiality policies, including compliance with HIPAA and Mahaska Health training requirements.

The work environment includes, but is not limited to:

• Work is performed in a well-lighted, well-ventilated healthcare office or hospital setting, including oncology clinics, administrative offices, and shared workspaces.
• Regular interaction with patients, caregivers, providers, nursing staff, insurance representatives, revenue cycle personnel, and other healthcare professionals regarding financial and billing-related matters.
• Prolonged periods of sitting, viewing computer screens, data entry, reviewing reports, and performing detailed financial analysis requiring close attention to accuracy.
• Exposure to routine office noise levels including telephones, printers, conversations, and other administrative equipment.
• Managing multiple priorities in a fast-paced environment, including financial coordination, billing review, insurance verification, authorization processes, and patient account support.