MD Anderson Cancer Center Jobs

Job Information

MD Anderson Cancer Center Financial Clearance Coordinator(RN) in Houston, Texas

Mission Statement

The mission of The University of Texas MD Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

SUMMARY

The Financial Clearance Coordinator is responsible for creating a positive patient experience by accurately and

efficiently handling the day to day operations relating to financial clearance activities. This includes adherence

to the department's policies and procedures related to the verification of eligibility/benefits, pre-authorization

requirements, available payment options, financial counseling and other identified financial clearance related

duties. The Coordinator will use their clinical knowledge and judgment to facilitate with the timely resolution

of issues related to the financial clearance process, including assessment and interpretation of the patient's

clinical condition, preparation of medical necessity justifications and assistance with peer to peer engagement.

KEY FUNCTIONS

  1. Obtain and document verification of patient eligibility (and applicable effective dates) using the

available institutional and/or payor systems, including real-time web portals and tools, within the

applicable timeframes as outlined by department policies and procedures. Promptly notify Patient

Access and the patient, when eligibility information is invalid and/or cannot be verified

  1. Work collaboratively with Patient Access to document updated and/or corrected insurance information

into the system in accordance with applicable department policies and procedures

  1. Obtain and document verification of patient benefits, including information regarding the product type,

in-network or out-of-network status, all applicable co-payment, deductible, and co-insurance amounts or

percentages, pre-existing indicator and time period, and any lifetime or annual maximums into

electronic health record in a timely manner

  1. Timely manage work lists for cases requiring pre-authorization and work directly with the payor or

assigned third party vendor to obtain all required pre-authorizations. Seek to obtain pre-authorization

through on-line web portals and tools, when available. Accurately document all reference and preauthorization

numbers, along with payor contact information, into electronic health record in a timely

manner

  1. Uses clinical knowledge and judgment to facilitate with obtaining pre-authorization on and provides

support to the Associate when clinical input, interpretation, medical necessity justification and peer to

peer engagement is needed

  1. For patients participating in a clinical trial, appropriately document and review with patients and the

payors services being covered by the clinical trial sponsor and those designated for coverage under the

patient's insurance

  1. Provides assistance with financial counseling to patients which includes reviewing (developing) cost

estimates, assistance with calculating expected patient liability, discussions regarding payment

requirements, collection of financial amounts dues, provide information regarding available payment

plan options, and provide information regarding patient financial assistance opportunities when

applicable. Financial counseling also includes reviewing ABN, MSPQ, account review and any other

barriers to financial clearance with patients as needed

  1. Complete and timely submit all documents (PFA, COBRA, etc,) requiring Supervisor approval for

financial clearance

  1. Provides support to the Associates as needed and promptly escalate any issues with financial clearance

and/or counseling to the Financial Clearance Supervisor, when needed

  1. Completely and accurately document conversations and communication with Patient Access, payors,

third party vendors, patients, and any other representative in and outside of the institution

  1. Answer emails and phone calls in a timely manner, and respond to voicemails and myMDAnderson

messages within one business day

  1. Conducts all financial clearance activities in a courteous and professional manner and maintains a

positive working relationships with patients, physicians, payors, third party vendors and any other

identified business partners

  1. Seeks to improve job performance and personal growth by participating in available educational,

training and mentoring opportunities

  1. Perform all other duties as assigned

REQUIREMENTS

Experience

Required: Two years' experience in nursing or one year related nursing experience in utilization review, insurance, case management, or medical clearance.

Education

Required: Graduation from an accredited school of nursing.

Certifications/Licenses

Required:Current State of Texas Professional Nursing license (RN). Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR) certification.

Preferred: American Heart Association Basic Life Support (BLS),- ACLS (Advanced Cardiac Life Support) or PALS (Pediatric Advanced Life Support) certification as required by patient care area.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html

Additional Information

  • Requisition ID: 133950

  • Employment Status: Full-Time

  • Employee Status: Regular

  • FLSA: exempt and not eligible for overtime pay

  • Work Week: Days

  • Fund Type: Hard

  • Pivotal Position: No

  • Minimum Salary: US Dollar (USD) 79,600

  • Midpoint Salary: US Dollar (USD) 99,500

  • Maximum Salary : US Dollar (USD) 119,400

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