Patient Eligibility Specialist Oncology

Patient Eligibility And SupportAre you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible.The Patient Eligibility and Support is an integral member of the Bassett Cancer Institute, provides financial counseling and guidance for patients through various resources. Performs pre-determination of eligibility / authorization for selected treatments, procedures and visits prior to date of service.

Determines self-pay status of patients and works closely with other Bassett clinical departments and support programs to assist patients in understanding and meeting financial obligations. Forms close working relationships with Cancer Institute staff, billing staff, and front-end staff assuring the best possible front-end processes for full and complete capture of revenue and patient services. Provides Presumptive Eligibility and Medicaid determination for patients. Assists patients in acquiring public health plans as appropriate.

Works closely with local Departments of Social Services within Bassett's service area as well as Bassett's health plans and local Community Service organizations providing Facilitated Enrollment services.Provides complete Insurance Support Services to front end processes as well as to Bassett patientsDetermine eligibility status of assigned patients scheduled as self-pay within 5 business days of DOSRefer true self-pay patients to appropriate clinic staff as well as CSP programAs appropriate determine self-pay patients' eligibility for other public insurance programsProvide presumptive eligibility and application assistance for appropriate patients as neededVerifies Medicaid status of selected Medicaid patients within 5 business days of DOSProvides verification and eligibility status on "high ticket" outpatient procedures as assignedWork closing with CSP program, develops process to reduce MedSpar recalls from front end workWork closely with billing office to identify front end denial trends and develops intervention actionsProvides coordination with the patient, insurance company, and hospital on the complete pre-certification process, which includes second opinions and tertiary referralsProcess additional information requests and coordinate with the insurance biller on requests for letters of medical necessity from and to insurance companiesReview patient chemotherapy protocols and determine insurance benefits and patient responsibilityAssist with SSI or SSDAssist and/or process STD (short term disability) formsAssist with payment arrangements for patients with outstanding patient balancesAssist fund managementAssist patients with treatment cost analysisEducate patients about financial resourcesAssist with obtaining or understanding insurancesInformation ManagementDevelop working knowledge of Bassett payer system and financial classificationsAssist system administrators in providing coaching for end users on system data entryMaintain department specific data bases and data management processesPerforms other duties as requested and observed by supervisor or managerEducation:2 Year/Associate Degree in health related field, preferredExperience:Preferred minimum 3 years of work-related experience:in healthcare, eligibility/verification processes and systemsworking with uninsured and Medicaid patientsknowledge of NYS presumptive eligibility/facilitated enrollment processesknowledge of public health insurance programs and other community resources available to the disadvantagedexperience working with diverse groups of individuals from a variety of cultural, socioeconomic and educational backgroundsExperience in one-to-one counseling and coaching, preferredSkills:AccountabilityAdvocacyAttention to DetailCommunicationCommunity RelationsComputer SkillsNetworkingResponsibilityTime ManagementPhysical Requirements:Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are metOccasional grasping, lifting, pulling, pushing, reaching, standingFrequent typing/clerical/dexterity, hearing, repetitive motion, seeing/monitor/computer use, talking, visual acuity (color, depth, perception), walkingTravel:No travel requiredBassett Healthcare Network's commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind. Many of the benefits we offer are paid fully or in large part by Bassett.

Our generous benefits offerings include:Paid time off, including company holidays, vacation, and sick timeMedical, dental and vision insuranceLife insurance and disability protectionRetirement benefits including an employer matchAnd more!Specific benefit offerings may vary by location and/or position.Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards. The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement.USD $16.98/Hr. USD $25.47/Hr.We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.