Oncology Financial Navigator – Insurance & Aid Programs

UCSF Health, AG; Burlingame (CA); Hybrid; USD 65,000 - 85,000; Full time

Job summary

UCSF Health in Burlingame and San Mateo is seeking a Financial Counselor to manage insurance coverage review, self-pay workflows, and patient assistance programs throughout oncology care. The role focuses on maximizing reimbursement and guiding patients through medical financial processes in both clinic and infusion settings.

The candidate will analyze denial trends, develop procedures, and maintain expertise on Medicare/insurance contracts, while collaborating with physicians, pharmacists, and

Qualifications

• Thorough knowledge of billing and / or collections processes, concepts, systems and external regulations.
• Knowledge of medical terminology and coding.
• Advanced knowledge of the multiple billing and accounting systems used, including coding, calculating reimbursement rates, filing appeals, conducting interviews and research, and interacting with customers, insurers, and other parties.
• Advanced analytical skills to produce comprehensive reports and identify trends and variations.
• Strong interpersonal and customer service skills to work effectively with all parties to the billing and collection process, and to productively negotiate terms for successful resolution of outstanding accounts and problems.
• Ability to communicate with patients under challenging circumstances on sensitive financial topics.
• Strong ability to provide recommendations on issues of functionality and operations in billing.
• Ability to serve as a resource, providing expertise and education to staff and management at all levels.
• Strong computer proficiency in all relevant hardware and software, with a knowledge of spreadsheet and accounting applications, and a variety of specialized billing and insurance systems.
• Knowledge of patient assistance programs that assist in minimizing the financial toxicity of cancer care and treatment.
• Solid interpersonal skills for effective information exchange and problem solving with all levels of management and staff, consultants, and outside agencies.

Responsibilities

• Lead projects and analyze insurance denial trends.
• Develop and implement procedures and systems to support efficient workflows and maximize reimbursement.
• Assess financial toxicity and screen patients for eligibility and enrolling patients on applicable patient assistance programs.
• Collaborate with providers and pharmacists to assess alternative treatments as appropriate to clinical indication.
• Develop, lead, and maintain expert knowledge of Medicare and insurance contract requirements.
• Provide cost estimates and ensure patients complete the financial process prior to treatment.
• Manage RFIs arising from denials.

Skills

Billing and collections

Insurance workflow

Financial counseling

Medicare & insurance contracts

Communication with patients

Education

HS Diploma/GED

Bachelor's degree

Tools

Billing software

Electronic medical records (EMR)

Job description

UCSF Health in Burlingame and San Mateo is seeking a Financial Counselor to manage insurance coverage review, self-pay workflows, and patient assistance programs throughout oncology care. The role focuses on maximizing reimbursement and guiding patients through medical financial processes in both clinic and infusion settings.

The candidate will analyze denial trends, develop procedures, and maintain expertise on Medicare/insurance contracts, while collaborating with physicians, pharmacists, and