Cellular Therapy Finance Specialist
Cancer care is all we do
Hope in healing
Cancer Treatment Centers of America® (CTCA), part of City of Hope, takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.
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 financial risk. The finance specialist works collaboratively with cellular therapy intake and transplant coordinators, finance, and clinical team to help provide financial decision support for clinical operations and to positively impact the revenue cycle.
- 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 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 senior finance specialist.
- Works independently under general supervision, leads and follows structured work routines. Works in a fast paced, multitask environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided.
Experience Minimum 3 years in related field
Education Associates Degree
Special Skills Working knowledge of medical and hematology/oncology terminology
Training Annual Stem Cell Transplant & CAR-T
>3 years in stem cell transplant
Working knowledge of stem cell transplant, CAR-T, and malignant hematology terminology
Pay Range$42,325.92 - $69,713.28
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.
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. Visit: Jobs.cancercenter.com to begin your journey.
We win together
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us.
Visit: Jobs.cancercenter.com to begin your journey.