All the benefits and perks you need for you and your family:

-          Benefits from Day One

-          Paid Days Off from Day One

-          Career Development

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift:    Day

The community you’ll be caring for:

Location:   Maitland:  900 Winderley Place, Maitland, 32751

• The Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources.
• The Trickle Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel.
• The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.
• We offer great benefits with immediate Health Insurance coverage
• Career growth and advancement potential 

The role you’ll contribute:

The Revenue Cycle Subject Matter Expert (SME) supports the benefits, authorization, scheduling, and financial assistance teams by collecting, analyzing, and preparing quality data for educational purposes that positively impacts oncology services. This position works closely with the oncologist, pharmacy, cancer institute, and nursing teams to coordinate education that increases clinical awareness to the revenue cycle teams that will optimize the benefits & authorization turnaround time and decrease scheduling errors serviced in the infusion centers and radiation oncology service lines.  The Oncology SME performs as a subject matter expert of all revenue cycle systems and oncology medical terminology through comprehensive understanding of operational workflows combined with an understanding of clinical knowledge to improve process and efficiency within the revenue cycle benefits, authorization and scheduling teams. This collaboration includes assessing, planning, developing, implementing, and evaluating performance for educational purposes and revenue cycle performance.

The expertise and experiences you’ll need to succeed:

Minimum Qualifications:  

 High School Grad or Equivalent and 2+ years’ experience in hospital

KNOWLEDGE AND SKILLS REQUIRED:

·         Proficiency in Microsoft (Word, Excel, and Access)

·         Effective oral and written communication skills

·         Self-directed with ability to be part of a team

·         Knowledge of medical terminology and understanding of clinical concepts

·         Ability to speak confidently with physicians and leadership

·         Ability to make decisions quickly

·         Knowledge of insurance practices regarding benefits, authorizations, and appeals

·         Knowledge and competence in clinical pharmacy services

 Preferred Qualifications:

• Current certification from Pharmacy Technician Certification Board (PTCB) or from the Institute for the Certification of Pharmacy Technicians (ICPT)N/A

·      Registered with the State of Florida Board of Pharmacy as a Pharmacy Technician (after Jan 1, 2010)

·      CHAA (Certified Healthcare Access Associate) from NAHAM (National Association of Healthcare Access Management)

·      Payer Guidelines

·      NCCN (National Comprehensive Cancer Network) Guidelines

·      Associate or bachelor’s degree (business, healthcare or health services administration, health information management, communications, finance, accounting, public administration, human resources, management, or marketing).

 The value you’ll bring to the team:

·               Implements, supervises, and monitors processes related to insurance eligibility, verification of benefits, financial assistance, and pre-authorization of services to ensure complete financial clearance is achieved. Works with team to ensure appropriate expectations are met for accurate insurance verification, pre-authorization, scheduling, and collection standards for the oncology specialty.  Remains up to date with Oncology Medications, Preferred and Reimbursable Drugs, Payer and National Comprehensive Cancer Network Guidelines.

·               Develops, implements, and maintains ongoing training for revenue cycle team that positively impacts benefits, authorization, financial assistance, and scheduling functionality for the oncology specialty. Helps support and train customers/vendors, revenue cycle support staff, and internal/external stakeholders on revenue cycle applications and processes with basic expertise as it relates to the oncology specialty.

·               Maintains knowledge of payer requirements and assists in chart review when clinical background is needed to make a determination. Works with physician offices and practice pharmacists to facilitate medication changes to treatment plans when a preferred drug is requested by the payer.

·               Audits performance and provides education to front line staff to maintain or exceed accuracy level standards. Provides constructive feedback that motivates the team and enhances knowledge to assist in meeting accuracy standard goals, patient safety, minimize department errors, rejections, and avoidable denials. Specifically audits and ensures authorization approval dates and CPT codes are accurate, and verifies any other items used for procedures to aide in reduction of avoidable denials and write offs.

·               Review infusion center schedules to triage workload and workflow issues across multiple facilities to optimize use of labor and ensure schedule is appropriately distributed for nursing resources based on regimen and patient acuity and recommend changes as needed.

·               Collaborates with the infusion centers, providers offices, corporate education, revenue cycle leaders to assess trends, and performs root cause analysis on key pain points. Recommends process and technology enhancements to drive process and financial performance.

·               Responds to patient and physician inquiries and directs to the appropriate physician/physician group based on the patient’s condition.  Responds to customer letters, email correspondence, or questions directly from patients, administrators, or hospital staff, securing necessary information to resolve issues within specified timeframes.

·               Assists in preparing policies and procedures, training materials, and provides any necessary information to revenue cycle teams to have comprehensive understanding of oncology treatment or therapy plans. Assist with reviewing as well as storing and organizing of compendia for easy access to team when needed for treatments outside of guidelines.

·               Demonstrates a proactive attitude and seeks to remedy situations before mistakes are made or corrects errors when found; take responsibility for the overall quality of the department.

·               Knowledge of and utilizes statistical approaches, measurement techniques, including benchmarking and comparative data to develop quality reports. Provide actionable optimization data (Pivot tables, formulas, filtering, charts, etc.) to allow for end users to improve their efficiency and that of the technology.

·               Serves as a consultant to team to provide education resources in oncology specialty. Offers guidance and assists in resolving process issues related to team education.

·               Seeks new learning opportunities for evidence-based practices and application.

·               Participates in the program meetings and practices continuous process improvement.

·                Performs other duties as assigned.