Job Description

Senior Financial Specialist, Stem Cell Therapy

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.

Job Description:

The Senior Specialist, Hematopoietic Cell Transplantation Immune Effector Cell Therapy (HCT/IEC) has an all-encompassing role that begins prior to each patient’s journey, continues throughout the entire treatment process, and post patient care at CTCA, a part of COH (CTCA/COH). The Senior Specialist provides leadership and works collaboratively with the City of Hope managed care team, HCT/IEC clinical team, liaises with revenue cycle management, and enterprise contracting to help provide financial decision support for clinical operations and positively impact the revenue cycle.  The Senior Specialist is a subject matter expert in commercial payer autologous and allogeneic stem cell transplant and CAR-T contracts; acts as liaison with the National Marrow Donor Program (NMDP) billing network, and commercial payer transplant case managers and billing representatives. Collaborates with the CTCA/COH transplant coordinator/authorized representative to secure authorization for all patient HCT/IEC medical services, safeguard reimbursement, and minimize patient financial risk. The Senior Specialist is responsible for verification of HCT/IEC benefits and provides patient financial counseling; is expert in self-pay agreements, registration, precertification, and partners with Revenue Cycle to ensure accuracy in coding and billing to optimize timely reimbursement.

JOB RESPONSIBLITIES

  • In collaboration with the HCT/IEC team, pursue appropriate documentation to support clinical procedures and ensure timely authorization to support patient care and maximize reimbursement. Routinely influence the approval process through their knowledge of HCT/IEC payer policy and subject matter expertise.

  • Work directly with the NMDP, commercial payers, and enterprise contracting to ensure all patient-related services meet criteria and is compliant with the guidelines of payer contracts for HCT/IEC. 

  • Analyze and partner with Revenue Cycle to ensure collaborative workflows regarding HCT/IEC to achieve and sustain accurate and timely billing and collection of accounts receivable. Responsible for identifying trends in HCT/IEC billing, collections, and posting errors with the goal of ensuring quality and program financial solvency through department compliance in all regulatory and contracted areas

  • Serve as primary point of contact for Revenue Cycle to resolve HCT/IEC insurance claim denials to include high dollar complex accounts. As needed, will be responsible for escalating approval issues to the clinical staff and physicians.

  • Utilize and maintain current knowledge of state and federal guidelines, patient account management techniques and information systems for registration, charge entry, coding, billing, clinical research, medical records, and accounts receivables in relation to HCT/IEC in the effort of optimizing communication and mutual understanding with the Revenue Cycle team

  • Serve as a subject matter expert HCT/IEC resource to patient accounting stakeholders. Liaise with revenue cycle management to ensure accuracy in coding and billing, and to maximize reimbursement for all stem cell transplant and CAR-T services per the terms of each payer contract.

  • Maintain accurate statistical, contractual, and financial databases related to autologous and allogeneic stem cell transplant and CAR-T programs. Prepare, analyze, and audit statistical data and reports for HCT/IEC program specific financial indicators. Provides leadership in ensuring the HCT/IEC program meets key metrics and efficiency in accounts receivable.

  • Collaborate with City of Hope managed care, COH-CTCA financial leadership and revenue cycle teams to manage key financial processes regarding HCT/IEC including operating budgets, forecasts, program reporting and analysis, charge management, cost accounting decision support, and reimbursement analysis.

  • Provide patient financial counseling specific to their transplant and CAR-T benefits, and self-pay agreements. Will assist patients with alternative arrangements for payment resolution.

JOB QUALIFICATIONS

Experience: Minimum 3 years in stem cell transplant experience in financial coordination, insurance authorization & coding, billing, and claims processing

Education: Associates Degree

Special Skills: Working knowledge of stem cell transplant terminology

Training: Annual Stem Cell Transplant & CAR-T

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.

Application Instructions

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