"Cellular Therapy Financial Counselor"

Job Summary

The Cellular Therapy Financial Counselor is responsible for coordinating all financial phases of Stem Cell Transplant and Immune Effector Cell (IEC) therapy at Dana Farber Cancer Institute and its partner facilities, including a detailed review of insurance benefits covering transplant and Immune Effector Cell services, coverage maximums and limitations, patient financial responsibility and confirming other benefits ancillary to the transplant and IEC (i.e. dental coverage, home healthcare, rehab, retail pharmacy coverage, travel and lodging benefits).

The Cellular Therapy Financial Counselor secures all required referrals/authorizations for each phase of the transplant and IEC prior to the services performed and is responsible for effectively communicating the patient’s financial status with the Clinical Team at each phase and working with the Clinical Team to escalate referrals/authorizations and coverage issues or temporarily defer the start of a phase under direct supervision.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS, and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Primary Duties and Responsibilities:

Under direct supervision, the Cellular Therapy Financial Counselor:

• Accepts transplant and IEC team assignments from the Clinical Team and begins the detailed review of transplant and Immune Effector Cell (IEC) benefits, including preparing the Transplant and IEC Patient Introduction Letter and updating and completing registration.
• Verifies eligibility and coverage for transplant and / or IEC services. Pursues insurance approvals and coverage by submitting medical documentation required for referral/authorization at each phase of the transplant and IEC, including IEC and transplant evaluation, donor search, workup and post-transplant and IEC follow up care.
• Acts as the liaison for Dana-Farber Cancer Institute and its partner facilities for the insurance Case Manager/Medical Director and patient.
• Participates in weekly Clinical Team meetings and communicates the patient’s financial clearance status necessary to assist with clinical decision making. Coordinates with patient/provider in appealing denied services, including coordinating peer to peer conferences.
• Serve as a resource to patients, families and staff regarding transplant and IEC financial issues through policy explanations, financial assistance program discussions, and application assistance.
• Prepare Financial Waivers and Advanced Beneficiary Notices (ABN) for patients with insurance plans that may not cover transplant or IEC services at Dana Farber Cancer Institute.
• Complies with all transplant and IEC billing practices including updating the appropriate billing plans in Dana Farber’s Hospital Information System as well as updating third party websites with clinical dates and submission of administrative documents required by payers at time of admission.
• Performs review of each patient visit to determine if visit was transplant related for accurate billing to occur.
• Documents all patient account correspondence in the appropriate note field, designated forms, or databases; this includes all phone calls incoming and outgoing, referral/authorization number data, and any other account knowledge that becomes available.
• Performs other duties and projects as assigned.

Knowledge, Skills and Abilities:

• Knowledge of insurance coverage verification, detailed benefit investigation, or clinical authorizations.
• Knowledge and comprehension of ICD-10 and CPT coding, medical terminology, or insurance standards and regulations.
• Knowledge of managed care policies and medical terminology.
• Knowledge and understanding of prior authorization and billing practices.
• Knowledge and understanding of the bone marrow transplant and IEC process and related billing practices.
• Knowledge of hematology/oncology and/or cellular therapy services is preferred.
• Excellent customer service and communication skills.
• Analytical problem-solving skills and mathematical/ accounting skills.
• Good technical skills with experience with Microsoft Office and Epic.
• Ability to prioritize and meet pre-determined deadlines.
• Ability to develop and maintain relationships with the clinical teams, case managers and other contacts.

Minimum Job Qualifications:

Minimum Education:
High school diploma or GED required; associate’s or bachelor’s degree preferred.

Minimum Experience:
0 years of experience required, 2 years of relevant work experience in a hospital or ambulatory setting, including hospital/physician office registration, financial counseling and billing experience preferred.

Supervisory Responsibilities: None

Patient Contact: Yes