About City of Hope

City of Hope is an independent biomedical research and treatment organization for cancer, diabetes and other life-threatening diseases.

Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution.  AccessHope, a subsidiary launched in 2019 serves employers and their health care partners by providing access to City of Hope’s specialized cancer expertise.

A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s "Best Hospitals" in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California, Arizona, Illinois and Georgia. 

Job Description:

Hours: Mon - Fri 8am - 5pm (occasional extended hours maybe needed)

Location: Newnan, GA.

This is not a remote position. Must be able to work onsite

JOB SUMMARY

The Cellular Therapy Finance Specialist is responsible for the front-end verification of patients’ transplant, CAR-T, and leukemia service benefits from intake to throughput. The finance specialist understands unique payer contracts, self-pay agreements, patient registration, precertification, authorization process, and maintains accuracy in coding and billing to ensure timely reimbursement. The finance specialist interacts directly with payers to secure insurance authorization for patient transplant, CAR-T, and leukemia medical services to safeguard reimbursement and minimize patient and organization financial risk. The finance specialist works collaboratively with cellular therapy clinical team, patient intake and transplant coordinators, quality, finance, and revenue cycle to help provide financial decision support for clinical operations and to positively impact the revenue cycle. The Cellular Therapy Finance Specialists will participate in meetings relevant to the position, collaborate with the Cellular Therapy Program Quality, Regulatory and Compliance team to establish performance metrics, track cellular therapy financial performance, and report on key performance measures/indicators to the Cellular Therapy Program leadership team and Cellular Therapy Program Quality Assurance and Improvement Committee.     

JOB RESPONSIBLITIES

• Verifies patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing. Assesses need for alternative coverage sources.

• Provides financial counseling to patients and their families specific to their stem cell transplant, CAR-T, leukemia benefits, and self-pay agreements. Serves as the primary resource throughout the patient’s treatment. Discusses benefits and other financial issues with patients and/or family members from initial referral through continuation of care.

• Works in alignment with the cellular therapy intake and transplant coordinators to obtain authorizations and ensure timeliness of patient schedules and care. Routinely influences the approval process through their knowledge of payer policy and subject matter expertise, pursuing the appropriate documentation to support clinical procedures. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement.

• Obtains all necessary signatures and documentation required by the patient’s insurance plan. Performs pre-registration/registration processes.

• Maintains current working knowledge of Medicare, Medicaid, Commercial payor and other program benefits and criteria, particularly as they pertain to long-term care and low-income patients.

• Monitors and updates information regarding insurance data, authorizations, preferred providers, and changes in patient’s treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patient’s care and maximum reimbursement and minimized financial impact to the patient.

• Act as a resource to patient accounting stakeholders. Review and problem solve insurance claim denials. Responsible for escalating approval issues to the cellular therapy finance and clinical leadership team.  

• Utilize and maintain current knowledge of patient account management techniques and information systems for registration, coding, billing, medical records, and accounts receivables.

• Maintains accurate statistical, contractual, and financial databases related to stem cell transplant and CAR-T programs. Analyzes statistical data and reports for program specific financial indicators under the direction of the Director of Cellular Therapy Program and senior finance specialist.

• Under the direction of the Director of Quality, Regulatory and Compliance to develop and implement key performance metrics and/or quality indicators that will be used to track and monitor Cellular Therapy Program financial performance and report on key performance measures/indicators to the Cellular Therapy Program leadership team and Cellular Therapy Program Quality Assurance and Improvement Committee.     

JOB QUALIFICATIONS

REQUIRED

• Experience: 3-5 years in related field; Experience in stem cell transplant highly preferred

• Education: High school diploma or GED; Associate degree preferred

• Special Skills: Working knowledge of medical and hematology/oncology terminology

PREFERRED

• Special Skills: Working knowledge of stem cell transplant, CAR-T, and malignant hematology terminology

• Training: Annual Stem Cell Transplant & CAR-T

Pay Range

Placement within the identified pay range is based on individual and market factors including, but not limited to, experience, education, credentials (including licenses and certifications), geographic location, market competition, skill set (including market availability of required skills), assigned/anticipated job tasks, and level of responsibility.  These factors are considered without regard to an individual’s status as a member of any protect group pursuant to federal, state, and/or local law.

City of Hope’s commitment to Diversity, Equity, and Inclusion

We believe diversity, equity and inclusion is key in serving our mission to provide compassionate patient care, drive innovative discovery, and advance vital education focused on eliminating cancer and diabetes in all of our communities.  Our commitment to Diversity, Equity and Inclusion ensures we bring the full range of skills, perspectives, cultural backgrounds, and experiences to our work -- and that our teams align with the people we serve in order to build trust and understanding.  We are dedicated to fostering a community that embraces diversity - in ideas, backgrounds, and perspectives; this is reflected in our work and represented in our people.

Visit:  Jobs.cancercenter.com to begin your journey.