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The Cell Therapy Financial Counselor II is responsible for coordinating all financial phases of Stem cell transplant and Immune Effector Cell (IEC) therapy at Dana Farber Cancer Institute and its partner facilities, including a detailed review of insurance benefits covering transplant and Immune Effector Cell services, coverage maximums and limitations, patient financial responsibility and confirming other benefits ancillary to the transplant and IEC (i.e. dental coverage, home healthcare, rehab, retail pharmacy coverage, travel and lodging benefits).

The Cellular Therapy Financial Counselor II secures all required referrals/authorizations for each phase of the transplant and IEC prior to the services performed, and effectively communicating the patient’s financial status with the Clinical Team at each phase and working with the Clinical Team to escalate referrals/authorizations and coverage issues or temporarily defer the start of a phase with moderate supervision.

The Cell Therapy Financial Counselor II requires an advanced knowledge of managed care policies, medical terminology, and the clinical authorization process.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Under moderate supervision, the Cell Therapy Financial Counselor II:

+ Accepts transplant and IEC team assignments from the Clinical Team and begins the detailed review of transplant and Immune Effector Cell (IEC) benefits, including preparing the Transplant and IEC Patient Introduction Letter and updating and completing registration.

+ Verifies eligibility and coverage for transplant and / or IEC services. Pursues insurance approvals and coverage by submitting medical documentation required for referral/authorization at each phase of the transplant and IEC, including IEC and transplant evaluation, donor search, workup and post-transplant and IEC follow up care.

+ Acts as the liaison for Dana-Farber Cancer Institute and its partner facilities for the insurance Case Manager/Medical Director and patient.

+ Participates in weekly Clinical Team meetings and communicates the patient’s financial clearance status necessary to assist with clinical decision making. Coordinates with patient/provider in appealing denied services, including coordinating peer to peer conferences.

+ Serve as a resource to patients, families and staff regarding transplant and IEC financial issues through policy explanations, financial assistance program discussions, and application assistance.

+ Prepare Financial Waivers and Advanced Beneficiary Notices (ABN) for patients with insurance plans that may not cover transplant or IEC services at Dana Farber Cancer Institute.

+ Complies with all transplant and IEC billing practices including updating the appropriate billing plans in Dana Farber’s Hospital Information System as well as updating third party websites with clinical dates and submission of administrative documents required by payers at time of admission.

+ Performs review of each patient visit to determine if visit was transplant related for accurate billing to occur.

+ Documents all patient account correspondence in the appropriate note field, designated forms, or databases; this includes all phone calls incoming and outgoing, referral/authorization number data, and any other account knowledge that becomes available.

+ Assists in the training and mentoring of staff.

+ Assists in developing and maintaining training materials and other resources.

+ Provides escalation support and manages more complex situations and cases.

+ Provides feedback for quality or process improvement initiatives and projects, as required.

+ Performs other duties and projects as assigned.

+ **Minimum Education** **:**

+ High school diploma or GED required; bachelor’s degree preferred.

+ **Minimum Experience** **:**

+ 1 year required in current DFCI role as Cell Therapy Financial Counselor.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

+ Strong knowledge of insurance coverage verification, detailed benefit investigation, or clinical authorizations.

+ Strong knowledge and comprehension of ICD-10 and CPT coding, medical terminology, or insurance standards and regulations.

+ Strong knowledge of managed care policies and medical terminology.

+ Strong knowledge and understanding of prior authorization and billing practices.

+ Strong knowledge and understanding of the bone marrow transplant and IEC process and related billing practices.

+ Strong Knowledge of hematology/oncology and/or cellular therapy services is preferred.

+ Excellent customer service and communication skills.

+ Strong analytical problem-solving skills and mathematical/accounting skills.

+ Strong technical skills with experience with Microsoft Office and Epic.

+ Ability to prioritize and meet pre-determined deadlines.

+ Ability to develop and maintain relationships with the clinical teams, case managers and other contacts.

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are equally committed to diversifying our faculty and staff. Cancer knows no boundaries and when it comes to hiring the most dedicated and diverse professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.

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