Finance Specialist, Transplant, Full Time, Days

Jackson Health•Miami, FL

13d•Onsite

About The Position

The Transplant Finance Specialist is responsible for coordinating and clarifying the available financial resources for transplant patient care. This role involves managing financial aspects of transplant patient care, ensuring proper documentation, and acting as a liaison between patients, financial institutions, and the healthcare team.

Requirements

3 to 5 years of related experience.
High School diploma is required.
Ability to analyze, organize, and prioritize work accurately while meeting multiple deadlines.
Ability to communicate effectively in both oral and written form.
Ability to handle difficult and stressful situations with critical thinking and professional composure.
Ability to understand and follow instructions.
Ability to exercise sound and independent judgment.
Knowledge and skill in use of job-appropriate technology and software applications.
Valid license or certification as needed, based on the job or specialty.
Unit Specific Credential

Responsibilities

Complete the Medicare Time Study Cost Report on alternating weeks on a monthly basis, requiring a breakdown of work allocated for all pre/post-transplant patients.
Attend Committees/Support Groups as necessary, including weekly Listing Committees, MELD score review meetings, Quality Committee meetings, and patient/family support groups.
Be proficient in navigating OTTR, an application used to collect and store patient demographic, financial, and transplant-related information.
Perform patient interviewing and fact-finding tasks upon registration and pre-admission, collecting or verifying insurance and/or third-party information to assure funding and settlement of patient accounts.
Perform financial screening and pre-registration, acting as a point of contact to determine patient financial responsibility and credit level, and initiating collection processes.
Refer patients to the Department of Patient Financial Services for financial assessment and eligibility determination as needed.
Prepare and ensure proper documentation of the patient's account package, including hospital forms and copies of required documents, and ensure registration documents are scanned.
Facilitate pre-certification and authorizations for designated payors prior to appointments.
Accurately collect all pertinent demographic and funding information at the point of contact.
Complete cross-training to assist in other potential service departments.
Stay abreast of new healthcare trends and maintain knowledge of various payors and third-party funding.
Maintain patient appointment logs and/or productivity reports as assigned.
Maintain a working knowledge of basic medical terminology and inter-departmental functions.
Maintain appropriate inter-departmental communications to enhance patient services.
Input and retrieve data on a personal computer as needed.
Respond promptly to patient inquiries and telephone calls by the third ring, communicating in a friendly, courteous, and caring manner.
Ensure the proper financial classification of patient accounts in accordance with established guidelines and make financial classification changes when warranted.
Research outstanding account balances and initiate collection efforts as necessary.
Verify eligibility and authorizations from all third-party funding sources and obtain patient benefits.
Develop third-party funding and/or evaluate patients for referral to public medical assistance programs.
Monitor and work accounts receivable according to Patient Financial Services guidelines and contractual agreements.
Assist with the coordination of audits and refunds to patients and other third-party payors.
Interact with hospital-affiliated agencies and all County, State, and Federal Agencies.
Keep the supervisor informed on any unusual problems that may hinder the timely collection of an account.
Obtain required patient/guarantor signatures where applicable.
Answer all telephone inquiries regarding patient accounts.
Properly handle and process correspondence and incoming mail.
Initiate patient contact (in person, by phone, or correspondence) to secure necessary information for account funding.
Interpret contract items and apply them in the resolution of outstanding claims.
Reconcile daily account flow for future admissions/procedures.
Follow up on accounts in the Patient Benefits System.
Coordinate the financial clearance for potential transfers to JMH.
Respond to billing inquiries as necessary.
Perform charge entry, patient check-in, and check-out as applicable.
Obtain and verify detailed patient insurance benefit coverage for all phases of the transplant process, and assist in acquiring necessary referrals and authorizations.
Review benefit and other transplant financial issues with patients or family members during the initial evaluation, advising on insurance and billing issues and available options.
Serve as a patient financial liaison for patients and their families, assisting with questions concerning insurance and financial issues.
Monitor and update patient financial and demographic information regarding insurance, physicians, authorizations, and preferred providers.
Effectively communicate financial information to transplant team members, patients, and their families, emphasizing potential out-of-pocket expenses and addressing insurance coverage gaps, including assistance with identifying alternative funding options.
Facilitate resolution of patient billing issues.
Demonstrate behaviors of service excellence and CARE values (Compassion, Accountability, Respect, and Expertise).
Perform other related duties as assigned.