Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal.
Under the supervision of the PFS Manager and/or Senior Director, responsibilities include various aspects of the Outpatient Cancer Center receivable management for the Patient Financial Services (PFS) Department. Candidate must have the ability to work in a “stratified process environment.”
Roles & Responsibilities:
- Verify insurance and registration data for scheduled outpatient hospital treatments. May also be responsible for obtaining pre-certification.
- Enroll patients with deductibles and co-insurances with their commercial insurance in the co-payments assistance programs.
- Enroll Medicare patients with deductibles and co-insurances in open foundations, if applicable.
- If foundation funds are fully allocated refer patients with Medicare coverage only to apply for Medicaid or a secondary insurance carrier and if not eligible, to see if an exemption to policy can be made for Charity Care.
- Advise patients about copay assistance programs, eligibility requirements, reimbursement process (submitting EOB along with supporting documentation as well as what is not covered by program) & follow up on any questions or concerns.
- Maintain spreadsheets in order to keep track of the patients that have been approved on the co-pay assistance programs and foundations, patients who are pending enrollment & patients who are not enrolled or are ineligible for assistance.
- Responsible for collection of payments and maintaining daily transaction records of collected payments from the co-pay assistance programs and patients.
- Works very closely with Manager/Director and keeps them up to date on any issues or new information that has been obtained.
- Enroll patients in the "Free Drug Program" (through drug manufacturer) if the drug was denied by the insurance as "not medically necessary" or "off label" use.
- Order medications for patients participating in "Free Drug Program", keep updated records on spreadsheet & facilitate communication between finance & pharmacy team (when orders have been placed, approvals & if drug was billed to insurance in error).
- Associates Degree or high school diploma/GED plus 3 years of relevant experience
- Medical/hospital accounts receivable experience helpful.
- Accounts receivable knowledge (hospital/third party).
- Cancer billing, guidelines and regulation knowledge a plus
Strength Through Diversity
The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.
We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care.
Explore more about this opportunity and how you can help us write a new chapter in our story!
Who We Are
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.