Senior Transplant Financial Coordinator

University of Chicago Medicine•Chicago, IL

15d•Hybrid

About The Position

Join UChicago Medicine , as a Senior Transplant Financial Coordinator in our Transplant Department . The Transplant Institute provides exceptional, life-saving care to outpatients and incredible career opportunities for providers and team members. As a Transplant Services Specialist, you will serve as the first point of contact for patients, families, visitors, and staff to coordinate services with the Office of Patient Relations. As a Senior Transplant Financial Coordinator , you will manage all financial aspects related to Transplant clearance regarding all aspects of abdominal/cardiothoracic/stem cell and bone marrow transplant. Your responsibilities include conducting thorough reviews of insurance benefits, covering transplant services, coverage limits, and maximums. Additionally, you will oversee account maintenance for transplant recipients and living donors in transplant, if applicable. In this role, you will also perform financial and administrative tasks for patients accessing ancillary services related to transplant, such as dental care, pharmacy coverage, travel and lodging benefits, and home and health rehabilitation. You are responsible for monitoring the flow of revenue generated not only by the transplant recipient but also by any donor-related charges associated with that recipient. This position involves extensive utilization of the hospital’s revenue systems and clear communication of the patient’s financial status with the clinical team – including patients, physicians, nurses, insurance companies, donors and other hospital staff – at every phase. You will collaborate with these stakeholders to address and escalate referral, authorization, and coverage issues, especially if any phase of the services needs to be temporarily deferred. In this role, you will collaborate with insurance companies to secure the necessary authorizations for all phases of care and ensure timely payments for Transplant services, with limited supervision. You will also serve as a patient advocate when billing issues arise or when there are changes to their insurance coverage. This role requires an advanced knowledge of the program and managed care policies, medical terminology, revenue cycle work queue management and the clinical authorization process. Essential Job Functions With minimal supervision, the Sr. Transplant Financial Coordinator conducts the duties assigned to the Transplant Financial Coordinator. This includes, but is not limited to, receiving transplant cases from the clinical team and conducting detailed reviews of insurance eligibility, coverage, and transplant benefits. Pursues insurance approvals by submitting the required medical documentation for each phase, including evaluation, donor search, workup, and post-transplant follow-up. Provides financial counseling to patients via in-person rounding with physician team and meeting with patients to provide Medicaid applications and teaching, as applicable. Manages account workqueues to identify and correct potential billing errors, including ensuring accurate transplant plan codes, coverage, and effective term dates Coordinates with the clinical team to appeal denied services, resolve charge disputes, billing issues, and patient concerns, including arranging peer-to-peer conferences. Document all aspects of verification, pre-authorization, and communications promptly. Assists in training and mentoring staff; Helps develop and maintain training materials and resources Provides escalation support for complex cases, including Transplant/IV therapy authorizations

Requirements

Bachelor’s degree or equivalent with 8 years of experience working in medical insurance verification and/or healthcare finance areas
Minimum of 10 years related healthcare registration, billing and/or reimbursement experience required
Advanced understanding of financial clearance in healthcare setting is required
Proficiency in Microsoft Office and Epic systems
Advanced insurance authorization and registration techniques required
Background in medical terminology
Website Insurance Training (OneSource, Availity, Connex)
EPIC training & testing (Phoenix for solid organ candidates)
Ability to register patients rapidly and accurately
Strong communication skills and must be able to communicate courteously and effectively with physicians, payors, and staff
Ability to prioritize and work on several projects at once while maintaining communication with all invested parties
Ability to complete multiple tasks and work under pressure and in stressful situations
Ability to quickly learn new procedures
Ability to display compassion and empathy

Nice To Haves

Certified Revenue Cycle Representative (CRCR) certification preferred
Strong coding and billing experience or financial counseling background preferred
Ability to maintain confidentiality of patient information
Certified Transplant Financial Coordinator (CTFC) certification preferred

Responsibilities

Receiving transplant cases from the clinical team and conducting detailed reviews of insurance eligibility, coverage, and transplant benefits.
Pursuing insurance approvals by submitting the required medical documentation for each phase, including evaluation, donor search, workup, and post-transplant follow-up.
Providing financial counseling to patients via in-person rounding with physician team and meeting with patients to provide Medicaid applications and teaching, as applicable.
Managing account workqueues to identify and correct potential billing errors, including ensuring accurate transplant plan codes, coverage, and effective term dates
Coordinating with the clinical team to appeal denied services, resolve charge disputes, billing issues, and patient concerns, including arranging peer-to-peer conferences.
Documenting all aspects of verification, pre-authorization, and communications promptly.
Assisting in training and mentoring staff
Helping develop and maintain training materials and resources
Providing escalation support for complex cases, including Transplant/IV therapy authorizations