Specialist I, Patient Financial Services

The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it. MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe.

Registration/Verification/Pre-Authorization/Finances

Depending on area, does some or all of the following: 1. Counsels new patients prior to first appointment and secures referral and/or authorization. 2. Registers patient demographics and insurance information into hospital billing system. Secures all required documentation prior to the patient's first appointment.
3. Responsible for verifying insurance benefits and pursuing pre-certification for services that include, but are not limited to, chemotherapy including combination drugs, radiology tests, Physical Therapy and Occupational therapy services, and supportive drugs therapy.
4. Upon verifying benefits and pre-certifying services, responsible for communicating outcomes to clinical and administrative staff that are involved in the patient's care, and to the patients.
5. Contacts patient to discuss balances and payment responsibilities for services not covered by their insurance. Discusses hospital policies and procedures regarding insurance coverage and patient responsibility including required deposits and inpatient and outpatient balances. When applicable, calculates patient’s deposit. Informs patients about their financial responsibilities, options and actions to be taken.
6. Identifies problem accounts and refers them for resolution.

Information Management and Compliance

1. Follows departmental procedures for updating patient and insurance information to ensure accurate billing. Reviews and processes, within established time frames, insurance updates for established patients from different sources (i.e., hold bills, MSK portal...).
2. Keeps up-to-date on all applicable billing requirements, procedures, and systems by attending staff meetings, reading emails, reviewing manuals, and using Datapedia and resources on an ongoing basis.
3. Maintains a working knowledge of insurance carrier’s guidelines for pre-certification requests. Communicates any changes in requirements and or noticeable changes in reimbursement patterns by insurance carriers for services to management team.
4. Participates in and promotes the prevention, detection, and resolution of instances of non-compliance with departmental and institutional policies and procedures. Notifies leadership of any possible non-compliance.

Special Projects As Assigned

1. May be asked to participate/coordinate departmental projects such as process improvement, data analysis, report preparation.
2. May be asked to inquire and conduct investigations on specific accounts. Identify patterns and trends of both common and unique issues.

Closing:

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