Transplant Financial Coordinator

American Addiction Centers • Charlotte, NC

4d • $23 - $34 • Hybrid

About The Position

Obtain detailed patient insurance benefits for all transplant-related aspects, including outpatient drugs, specialty pharmacy drugs, follow-up clinic visits, travel, and housing. Review, monitor, and research insurance benefits and potential patient financial needs; discuss findings with patients and families; report to the transplant selection committee. Advise patients on insurance and billing issues; serve as a financial resource for patients and their families throughout the transplant process. Develop resolutions for potential patient financial out-of-pocket exposure; assist patients in planning and overcoming financial obstacles. Obtain necessary payor authorizations; verify transplant coverage and other medical benefits; acquire referrals and authorizations. Consult with clinical transplantation staff, including coordinators and physicians, to facilitate the submission of required medical documentation to insurance carriers; monitor and report the status of the financial clearance process. Communicate with transplant coordinators and social workers regarding patient approval status. Assist with inpatient and outpatient admissions and financial clearances to ensure smooth facility admissions. Create new patient accounts in the system/transplantation database by entering demographics and financial information. Monitor and update insurance data, physician authorizations, and preferred providers; document and provide updates. Work with the reimbursement and patient billing departments to flag transplant patient accounts for cost reporting. Collaborate with the contracting department to establish single case agreements when necessary; follow up on these payors and assist in contracting efforts. Attend patient multidisciplinary conferences to provide updates on financial clearance for patients awaiting organ transplantation. Coordinate efforts with admissions, business office, medical records, pharmacy, financial services, social services, and risk management for transplant intake and financial clearances. Consult with managed care organizations and release patient medical records to insurance carriers, referring providers, and dialysis units as appropriate. Collaborate with Finance and Managed Health Resources staff to ensure proper billing under global contracts/Center of Excellence agreements. Resolve conflicts involving authorization and reimbursement challenges. Participate in on-call coverage for insurance verification for incoming transplant patients as required.

Requirements

• High School Diploma/GED with 3 years of insurance related experience or associate's degree and 1 year of insurance related experience orbachelor's degree in related field

Nice To Haves

• Bachelor's Degree
• CFTC Certification
• Transplant insurance experience

Responsibilities

• Obtain detailed patient insurance benefits for all transplant-related aspects, including outpatient drugs, specialty pharmacy drugs, follow-up clinic visits, travel, and housing.
• Review, monitor, and research insurance benefits and potential patient financial needs; discuss findings with patients and families; report to the transplant selection committee.
• Advise patients on insurance and billing issues; serve as a financial resource for patients and their families throughout the transplant process.
• Develop resolutions for potential patient financial out-of-pocket exposure; assist patients in planning and overcoming financial obstacles.
• Obtain necessary payor authorizations; verify transplant coverage and other medical benefits; acquire referrals and authorizations.
• Consult with clinical transplantation staff, including coordinators and physicians, to facilitate the submission of required medical documentation to insurance carriers; monitor and report the status of the financial clearance process.
• Communicate with transplant coordinators and social workers regarding patient approval status.
• Assist with inpatient and outpatient admissions and financial clearances to ensure smooth facility admissions.
• Create new patient accounts in the system/transplantation database by entering demographics and financial information.
• Monitor and update insurance data, physician authorizations, and preferred providers; document and provide updates.
• Work with the reimbursement and patient billing departments to flag transplant patient accounts for cost reporting.
• Collaborate with the contracting department to establish single case agreements when necessary; follow up on these payors and assist in contracting efforts.
• Attend patient multidisciplinary conferences to provide updates on financial clearance for patients awaiting organ transplantation.
• Coordinate efforts with admissions, business office, medical records, pharmacy, financial services, social services, and risk management for transplant intake and financial clearances.
• Consult with managed care organizations and release patient medical records to insurance carriers, referring providers, and dialysis units as appropriate.
• Collaborate with Finance and Managed Health Resources staff to ensure proper billing under global contracts/Center of Excellence agreements.
• Resolve conflicts involving authorization and reimbursement challenges.
• Participate in on-call coverage for insurance verification for incoming transplant patients as required.

Benefits

• Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
• Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
• Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 11-50 employees