Transplant Financial Coordinator

American Addiction Centers

3d • $23 - $34 • Hybrid

About The Position

Department: 37802 Advocate Christ Medical Center - Transplant: Heart Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: 7 a.m. - 3:30 p.m. 1 day a week on campus. Transplant financial experience preferred. May need to take calls after hours/weekend for emergent cases Pay Range $22.90 - $34.35 Major Responsibilities: Performs and generates timely documentation of comprehensive financial assessment(s). Obtains insurance prior authorizations for high dollar medically necessary transplant evaluation, transplant, BTT VAD and DT VAD. Meets with patient during evaluation process to discuss transplant benefits, obtaining necessary information to determine areas of potential concern. Counsels and assists patients with decisions when insurance clearance is not obtained. Collaborates with the multi-disciplinary team in establishing/documenting goals and treatment plans for the patient. Meets with all potential living donors prior to the Selection Committee decision to review potential financial impact and pursues potential financial assistance resources. Participates in transplant team meetings. Establishes and maintains a working relationship with key contacts at insurance companies and other departments within the Aurora Health Care system. Communicates and coordinates with medical staff to provide up to date and accurate interpretation of patient’s medical status to insurance case managers. Collaborates with members of the transplant team to problem solve post-transplant medication issues. Pursues alternative funding resources for insurance coverage deficiencies, and completes all necessary applications and paperwork for pharmaceutical funding assistance programs. Provides ongoing patient education and support for transplant, VAD, Advanced Heart Failure (HF) Clinic and general surgical patients. Performs crisis intervention when financial issues arise post VAD implant/transplant. Follows up with patient in clinic or the bedside to assess financial needs/concerns, and make referrals as necessary. Participates in patient advocacy, resource brokering, and information and referral services. Serves as general advocate for patients and their families throughout the pre-and post-transplant process. Maintains current knowledge of Medicare and Medical Assistance rules or any federal and state legislation affecting the transplant patients. Understands out of state Medicaid, Exchange plans and commercial payer networks including prescription drug provider networks in order to ensure proper coordination. Coordinates housing accommodations for patients. Maintains up to date documentation for all organ transplant listed patients, for the purpose of transplant re-authorizations and insurance changes. Communicates patient transplant contract information and coordinates patient contract billing issues to Transplant Billing Group. Facilitates and advocates a resolution of patient billing issues. Tracks monthly time study.

Requirements

• Associate's Degree (or equivalent knowledge) in Medical Billing or related field.
• Typically requires 5 years of experience in medical insurance benefit coverage assessment, processing and invoicing; including HMO and PPO experience.
• Knowledge of Medicare/ESRD rules
• Understanding of Marketplace regulations specific to transplant
• Independent discretion/decision making skills
• Ability to effectively work with professionals and non-professionals in situations of high complexity and high intensity in a positive and professional manner.
• Strong analytic, organization, communication (written and verbal), and human relation skills
• Strong interpersonal skills and sensitivity with patients and their families with regard to matters of health and personal finance
• Ability to plan, organize, prioritize, multi-task, and meet deadlines under stressful circumstances
• Knowledge of computer applications related to patient accounts processing
• Knowledge of medical terminology
• Knowledge of principles and practices of customer service and telephone courtesy

Nice To Haves

• Transplant financial experience preferred.

Responsibilities

• Performs and generates timely documentation of comprehensive financial assessment(s).
• Obtains insurance prior authorizations for high dollar medically necessary transplant evaluation, transplant, BTT VAD and DT VAD.
• Meets with patient during evaluation process to discuss transplant benefits, obtaining necessary information to determine areas of potential concern.
• Counsels and assists patients with decisions when insurance clearance is not obtained.
• Collaborates with the multi-disciplinary team in establishing/documenting goals and treatment plans for the patient.
• Meets with all potential living donors prior to the Selection Committee decision to review potential financial impact and pursues potential financial assistance resources.
• Participates in transplant team meetings.
• Establishes and maintains a working relationship with key contacts at insurance companies and other departments within the Aurora Health Care system.
• Communicates and coordinates with medical staff to provide up to date and accurate interpretation of patient’s medical status to insurance case managers.
• Collaborates with members of the transplant team to problem solve post-transplant medication issues.
• Pursues alternative funding resources for insurance coverage deficiencies, and completes all necessary applications and paperwork for pharmaceutical funding assistance programs.
• Provides ongoing patient education and support for transplant, VAD, Advanced Heart Failure (HF) Clinic and general surgical patients.
• Performs crisis intervention when financial issues arise post VAD implant/transplant.
• Follows up with patient in clinic or the bedside to assess financial needs/concerns, and make referrals as necessary.
• Participates in patient advocacy, resource brokering, and information and referral services.
• Serves as general advocate for patients and their families throughout the pre-and post-transplant process.
• Maintains current knowledge of Medicare and Medical Assistance rules or any federal and state legislation affecting the transplant patients.
• Understands out of state Medicaid, Exchange plans and commercial payer networks including prescription drug provider networks in order to ensure proper coordination.
• Coordinates housing accommodations for patients.
• Maintains up to date documentation for all organ transplant listed patients, for the purpose of transplant re-authorizations and insurance changes.
• Communicates patient transplant contract information and coordinates patient contract billing issues to Transplant Billing Group.
• Facilitates and advocates a resolution of patient billing issues.
• Tracks monthly time study.

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
• Education Level: Associate degree
• Number of Employees: 1-10 employees