Manager, Patient Financial Services
ProCure Treatment Centers - Seattle, WA

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The Patient Financial Services Manager is responsible for reviewing demographic, employment and insurance data necessary for payment of proton therapy treatment and verifies insurance coverage and benefits of our patients. Coordinates with Reimbursement Team to obtain PSAs (Patient Specific Agreements) when required. Assists patients with financial counseling related coverage / reimbursement of proton healthcare related expenses.

RESPONSIBILITIES
• Verifies insurance / financial information through a variety of means, ensuring that insurance information and authorizations provided are current, accurate and not approaching expiration
• Determines the insurance policy coverage regarding proton therapy, including, but not limited to, site, diagnosis, clinical and testing prerequisites, limits of coverage, patient responsibility, referral, pre-authorization, precertification requirements, etc.
• Documents necessary approvals from patients’ payer sources and patient
• Educates patients on the insurance approval process for protons and any associated ancillary services needed from partner facilities
• Provides explanations and/or guidance on insurance coverage and/or available community, local and/or regional resources for patients
• Utilizes internal / partner hospital’s electronic registration system
• Gathers information from non-participating insurance companies regarding department responsible for negotiating reimbursement terms
• Participates in the joint editing and feedback processes established between the Center and the Center’s contracted billing provider
• Assists Reimbursement Manager with monitoring of budgets
• Performs job activities using Electronic Medical Record (Mosaiq) and maintains a paperless patient insurance record
• Contributes to process improvement programs/initiatives
• Acts as key insurance interface between the Center and the partner physician practice(s)
• Maintains current knowledge of Radiation Oncology insurance requirements
• Offers process improvement ideas for insurance areas, to enhance patient satisfaction and improve results
• Records timely, accurate records of all patient demographic, insurance and billing information
• Adapts to change in process and procedure
• Other duties as assigned by Managers/ Directors

WORK EXPERIENCE REQUIREMENTS

• A minimum of 3 years experience in healthcare insurance
• Ideal candidate will possess experience healthcare insurance process, claims and coding
• Experience performing electronic registration, financial hardship applications, insurance eligibility and enrollment
• Experience interfacing with patients and their families regarding healthcare insurance coverage

REQUIRED SKILLS AND ABILITIES
• Healthcare insurance / claims expertise
• Exemplary customer satisfaction skills, including dealing effectively with customers, both in person and over the telephone
• Excellent written and verbal communication skills.
• Proficient using Microsoft office products and electronic registration systems
• Understands ICD-9 and CPT coding
• Medical terminology
• Experience using Mosaiq / IMPAC software preferred
• Understands management of patient accounts via outsourced billing providers

COMPETENCIES
• Problem Solving/Analytical Skills
• Organization, Attention to Detail & Time Usage
• Performance Standards/Results Orientation
• Competency/Dependability/Thoroughness
• Interpersonal / Communication skills

EDUCATION/DEGREE
• College Degree preferred
• Certified Medical Coder preferred

OTHER
• While this job description outlines the general duties and responsibilities of this role, the Financial Services Manager may be asked to perform other functions and duties as required or assigned
• ProCure utilizes RFID (Radio-Frequency Identification) tags at the centers for the purposes of analysis of productivity and patient throughput. This information is not for use as a management tool for employee performance issues.

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