Patient Financial Advocate- infusion

Minneapolis Clinic Of Neurology Ltd; Golden Valley (MN); On-site; USD 45,000 - 65,000; Full time

Job summary

Minneapolis Clinic Of Neurology Ltd is seeking a Patient Financial Advocate and Prior Authorization Coordinator to support the Infusion Center. You will review referrals, assist patients with insurance paperwork, and conduct comprehensive benefits investigations to determine financial responsibility before scheduling.

Collaborating with PFS, PA, and Infusion teams, you will verify coverage and authorizations, manage assistance programs, monitor billing issues, and help improve patient access and

Qualifications

• Experience in medical office billing or revenue cycle processes.
• Two years of medical office experience, preferably in revenue cycle or financial counseling.
• Experience with infusion services is highly desirable.

Responsibilities

• Receive and review referrals for completeness and patient needs.
• Assist patients with insurance paperwork and infusion start-up forms.
• Perform comprehensive benefits investigations and discuss costs with patients.
• Collaborate with PFS, PA, and Infusion teams to secure coverage and authorization.
• Confirm co-pay assistance, payer/manufacturer requirements and MCN account status.
• Apply for and manage grants, patient assistance, co-pay, and free drug programs.
• Monitor insurance accumulations and move patients to billable status when thresholds are met.
• Ensure start forms are current and submitted electronically when possible.
• Serve as resource for insurance, authorization and patient financial issues.

Skills

Insurance billing

Prior authorization

Customer service

Communication

Organization

Reading/writing

Medical terminology

Education

High School diploma or GED

Bachelor's degree in health-related field

Tools

MS Office

Electronic Health Record (EHR)

Job description

The Patient Financial Advocate and Prior Authorization Coordination

• Receive and review infusion referrals to ensure completeness and understanding of specific patient needs.
• Contact patients to assist with insurance paperwork and infusion start-up forms.
• Perform comprehensive benefits investigations for every patient, including verifying coverage, determining financial responsibility, and discussing costs with the patient before scheduling.
• Collaborate with the PFS, PA, and Infusion teams to ensure coverage and authorization are in place prior to appointments.
• Confirm co-pay assistance, payer, or manufacturer requirements, and MCN account status prior to infusion.
• Apply for and manage financial assistance programs including:

• Grants: Identify eligible patients, apply for funding, track available funds, and maintain renewals.
• Patient Assistance Programs: Determine financial need, complete applications, monitor renewals, and liaise with foundations.
• Co-pay Programs: Identify eligible patients and ensure enrollment for those who qualify.
• Free Drug Programs: Track all enrolled patients, maintain spreadsheets, order and confirm receipt of free drug shipments, coordinate with foundations, and manage retroactive coverage when applicable.

• Monitor insurance accumulations (such as out-of-pocket maximums) and transition patients from free drug programs to billable status when thresholds are met.
• Ensure start forms are current, accurate, and submitted electronically, when possible, for all infusion medications.
• Serve as a resource and expert problem solver for internal teams and external partners, assisting with insurance, authorization, and patient financial issues.

Administrative and Financial Operations Support

• Perform administrative and financial tasks to support Infusion Center operations, ensuring an efficient experience for both patients and staff.
• Research and maintain knowledge of drug supplier resources, government grants, charitable foundations, and co-pay assistance programs. Communicate new or updated program information to the Infusion Center Manager, PFS Manager, and other stakeholders.
• Monitor communication channels including in-baskets and fax folders for insurance issues, prior authorization updates, co-pay and referral forms, and other relevant documents.
• Collaborate with Infusion, Scheduling, and Billing teams to resolve discrepancies, billing concerns, and payer-related denials.
• Work closely with professional staff to share information, educate team members, and address patient concerns.
• Participate in process improvement initiatives by identifying workflow efficiencies and assisting in the implementation of new procedures that enhance patient access and experience.
• Manage and reconcile infusion visit tracking reports to ensure accurate and timely billing of all services.

Other Duties as Assigned

• Assist with general departmental initiatives and projects as directed by leadership.
• Support quality improvement activities and contribute to a culture of compassionate, patient-centered care.
• Provide backup support for colleagues during absences or high-volume periods.

Education and Experience:

• High School graduate or GED equivalent required. Bachelor's degree in health-related field highly desired.
• At least two years of previous medical office experience, preferably in the areas of revenue cycle or financial counseling.
• Previous experience with infusion services highly desired.

Knowledge, Skills, and Abilities:

• Strong knowledge of health insurance and its impact on billing. Knowledge of prior authorization process.
• Patient centered, strong customer service orientation. Excellent communication and interpersonal skills.
• Ability to be organized, work independently, exhibit mature judgment, and make sound decisions.
• Accurate and precise reading and writing skills. Strong command of the English language; good spelling/grammar.
• Knowledge of medical terminology and ICD-10/CPT coding.
• Ability to handle confidential information with the utmost judgment and discretion.
• Proficiency with MS Office, including Word, Excel, and Outlook. Proficiency with electronic health record.

III. Working Conditions:

Environment:

• Normal office environment.

Physical Demands:

• Requires long periods of sitting and working at computer terminal.

Equipment Used:

• Standard office equipment, including personal computer, telephone, and related technology.