Transplant Financial Coordinator-Hybrid

Mayo Clinic • Phoenix, AZ

2d • $29 - $40 • Hybrid

About The Position

The Transplant Financial Coordinator is an advanced-level position responsible for resolving referrals, precertification, prior authorization, and financial clearance throughout the pre-transplant and post-transplant process. The coordinator works professionally with patients to explain financial obligations and options for meeting financial requirements, including assessing financial assistance eligibility, determining insurance coverage eligibility, establishing payment arrangements, and collecting preservice payments and copayments as needed.

The role may cover workloads across all Mayo Clinic sites regardless of the representative’s physical location, and may include pre-appointment insurance review (PAIR) and denial-recovery functions within the Patient Access Prior Authorization department. Responsibilities include interpreting insurance eligibility and transplant contracts, and submitting Letter of Agreement (LOA) and Individual Case Negotiation (ICN) requests concerning network coverage or self-pay issues.

The coordinator may participate in transplant selection committee meetings from a financial perspective, helping inform decisions to accept or deny potential transplant recipients and determine listing status. The role may also collaborate with multidisciplinary teams to develop and implement transplant patient protocols and standards of care. It includes monitoring and updating documentation according to United Network of Organ Sharing (UNOS) guidelines, including listing, status changes, and post-transplant follow-up information, while meeting quality assurance guidelines and established productivity standards.

This is a hybrid position. The employee must be located within 100 miles of a Mayo Clinic campus for on-site expectations based on business needs. The position may require work covering all Mayo Clinic sites.

Requirements

• High school diploma or GED.
• At least 5 years of experience in medical billing (hospital and/or professional), customer service, and/or a finance-related field.
• Advanced knowledge of ICD-10 and CPT coding.
• Advanced knowledge of third-party payor referrals and authorizations.
• Excellent written and grammatical skills, including proper phone etiquette.
• Advanced computer and keyboarding skills.
• Must maintain regular and acceptable attendance.

Nice To Haves

• Associate degree or higher.
• Certification as a Transplant Financial Coordinator (CTFC).
• Healthcare Financial Management Association (HFMA) certification.
• Transplant financial counseling and billing experience.
• Financial, analytical, and mathematical competencies.
• Experience with Epic.
• Advanced knowledge of medical billing, reimbursement, and collections processes.
• Advanced knowledge of healthcare and transplant terminology.
• Knowledge of insurance contracts and managed care experience.
• Knowledge of solid organ transplants, bone marrow transplants (BMT), End Stage Renal Disease (ESRD), and Chimeric antigen receptor (CAR)-T cell therapy.
• Knowledge of transplant billing requirements.
• Knowledge of the Conditions of Participation (CoP), National Marrow Donor Program (NMDP), National Organ Procurement and Transplantation Network (OPTN), Scientific Registry of Transplant Recipients (SRTR), and federal rules and regulations for organ acquisition.

Responsibilities

• Resolve referrals, precertification, prior authorization, and financial clearance through the pre-transplant and post-transplant process.
• Explain patient financial obligations and options for meeting financial requirements.
• Assess financial assistance eligibility and determine insurance coverage eligibility.
• Establish payment arrangements and collect preservice payments and copayments as needed.
• Interpret insurance coverage eligibility and transplant contracts.
• Submit Letter of Agreement (LOA) and Individual Case Negotiation (ICN) requests for in/out-of-network coverage or self-pay issues.
• Perform pre-appointment insurance review (PAIR) and denial-recovery functions when assigned.
• Participate in transplant selection committee meetings from a financial perspective to help inform acceptance or denial decisions and transplant listing status.
• Collaborate with multidisciplinary teams to develop and implement transplant patient protocols and standards of care.
• Monitor and update documentation according to UNOS guidelines, including listing, status changes, and post-transplant follow-up information.
• Follow quality assurance guidelines and established productivity standards.
• Support workload across Mayo Clinic sites as assigned.

Benefits

• Multiple medical plan options.
• Dental coverage through Delta Dental or a reimbursement account for flexible coverage.
• Affordable vision plan with a national network.
• Health Savings Account (HSA) and Flexible Spending Accounts (FSAs) for eligible expenses.
• Competitive retirement package.
• Continuing education and advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED