1. Maintain extensive database for Third Party Assistance (TPA)
Programs for oncology patient financial assistance and continuously
monitor for changes and/or updates regarding each TPAs available
funding and their eligibility and enrollment requirements.
2. Meet with new patients and their caregivers to provide
patient-specific education on their insurance benefits and
estimated out-of-pocket expenses for their prescribed therapy prior
to treatment initiation.
3. Help patients complete applications for financial assistance,
pharmaceutical assistance, and government programs in a timely and
HIPAA compliant manner. Work closely with the Oncology Social
Worker on cross over patients and make referrals as necessary.
4. Track all TPA funding received and report the information to
the VP Oncology on a bi-monthly basis. Report trending and
forecasting on special projects as requested by VP Oncology.
5. Obtain all required insurance prior authorizations for oral
chemo and therapeutic medications prescribed by SCC providers;
liaise with specialty and local pharmacies as well as
pharmaceutical companies to coordinate medication delivery and
provide continuous status updates to patients regarding their
6. Serve as the oncology point of contact for all patient
billing questions and concerns; work directly with the Patient
Financial Services (PFS) staff to resolve all SCC patient billing
7. Submit patient claims and applications for financial
assistance in a timely and HIPAA compliant manner. Post all monies
received to the financial system and provide updates to patients as
funding is received on their behalf.
8. Liaise with pharmaceutical company representatives for both
IV and oral therapies to learn about their products, co-pay
programs and potential foundation assistance. Act as the first line
of contact for pharmaceutical reps and communicate applicable
changes/updates to the clinical team as appropriate.
9. Serve as an integral member of the SCC front office team who
provides coverage and assistance as needed for planned and
unplanned PTO/sick leave for the following positions: front
desk/patient access, insurance verification, and medical records.
Provide PTO coverage for the oncology business analyst as needed
and performs other duties as assigned.
10. Regularly attend weekly Chartrounds meetings with clinical
staff and communicate all pertinent patient information regarding
new treatment starts, treatment plan changes, and any urgent
patient needs to the appropriate front office staff.
11. Promote an atmosphere of warmth, compassion, and
understanding while demonstrating empathy and the ability to relate
to patients and their families. Seek first to understand and come
from a place of What if?
12. Role models the principals of a Just Culture and
13. Perform other duties as assigned. Must by HIPAA