Financial Counselor - Oncology
The Financial Counselor, Oncology, is responsible for meeting with patients and communicating insurance benefits and out-of-pocket responsibilities to develop appropriate financial plans. This role provides direct support for patients receiving outpatient oncology and infusion services. The Financial Counselor assists in completing all patient assistance and drug copay programs, including copay foundation applications, to secure external eligibility and internal financial support. When necessary, the counselor also facilitates and submits Medical Assistance applications (including Adult Category, Healthy Horizons, BCCPT, Emergency Medical Assistance, and MAWD) to help ensure uninterrupted access to treatment.
Essential Functions:
Demonstrates strong knowledge of healthcare insurance, particularly Medicare and Medicaid, and understands hospital and physician claims, insurance payments, and patient financial responsibility.
Manages all aspects of Oncology Patient Assistance Programs, including enrollment, submitting claims after insurance payments, and staying current with program and insurance policy changes.
Communicate effectively with the Medical Oncology team and leadership to resolve issues related to verification, registration, and benefit coordination, ensuring timely solutions.
Maintains strong technical skills, particularly in Microsoft Excel, and can navigate multiple systems to track and manage patient financial assistance efficiently.
Ensure compliance with payer requirements, HIPAA regulations, and internal protocols while consistently demonstrating professionalism and the hospital's core values in all interactions.
Competencies (Knowledge, Skills, and Abilities Required):
Thorough understanding of healthcare insurance plans, including Medicare, Medicaid, and commercial payers, with the ability to interpret benefit structures and patient responsibilities.
Proficiency in Oncology Patient Assistance Programs, including enrollment processes, copay card applications, foundation support, and manufacturer-sponsored programs.
Knowledge of state and federal financial assistance programs, including Medical Assistance categories (Adult, Healthy Horizons, BCCPT, Emergency MA, MAWD), with the ability to complete and submit applications accurately.
Ability to analyze hospital and physician claims to determine patient responsibility and assist with post-insurance financial support through available programs.
Strong computer skills, including Microsoft Excel, electronic medical records (EMR), and payer portals; comfortable navigating multiple systems simultaneously.
Exceptional communication and interpersonal skills, with the ability to clearly explain complex financial and insurance information to patients and collaborate with clinical and administrative teams.
Highly organized and detail-oriented, with the ability to prioritize multiple tasks in a high-volume, time-sensitive environment.
Professional, patient-centered approach, maintaining empathy and discretion when handling sensitive patient financial concerns.
Adaptability and problem-solving ability, particularly in navigating evolving payer policies and financial assistance guidelines.
Commitment to organizational values, maintaining respectful and effective interactions with patients, families, co-workers, and external partners.
Minimum Education and Experience Requirements:
Education:
High School diploma or GED required. Associates degree in Business/Healthcare preferred. Work experience may be considered in lieu of the Associates degree.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Thomas Jefferson University Hospitals, Inc.
Primary Location Address
3941 Commerce Avenue, Willow Grove, Pennsylvania, United States of America
