Transplant Financial Coordinator - UWMC-Montlake

University of Washington Medical Center•Seattle, WA

2d•$51,180 - $73,224•Onsite

About The Position

University of Washington Medical Center - Montlake Transplant Services has an outstanding opportunity for a Transplant Financial Coordinator. DEPARTMENT DESCRIPTION: Transplant Services at UW Medical Center - Montlake combines the clinical, academic and research activities of the transplantation and cardiothoracic surgery divisions at UW Medicine. Our board-certified surgeons perform most of the multi-organ procurements in Washington, Alaska, Montana and northern Idaho. We’re organized around the following multidisciplinary clinical teams, all of which provide transplant care with compassion, integrity and respect for individual dignity: heart transplantation, kidney-pancreas transplantation, liver transplantation, and lung transplantation. Through Seattle Children's, we offer pediatric kidney, liver and heart transplantation services. at UW Medical Center - Montlake also offers programs in autologous bone marrow transplants and high-dose chemotherapy. WORK SCHEDULE Full-time, 40 hours/weekly, M - F, Days POSITION HIGHLIGHTS Conveniently located near public transportation Make a difference for the patients and employees we serve Opportunity to provide career growth PRIMARY JOB RESPONSIBILITIES Obtain and document detailed patient insurance benefit information for all phases of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and lodging, if necessary Obtain all necessary authorizations from payers, verifying transplant coverage and other medical benefits and obtaining referrals and authorizations if required. Request a Benefit Level Exception (BLE) or a Single Case Agreement (SCA) as appropriate from the UW Medicine Contracting Department for non-contracted health plans Obtain all necessary information, including clinical documentation, required by payors for approval of different transplantation phases, including benefit verification, payor authorization, referrals, precertification, and case management Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems; initiate communication with appropriate agencies and clinical staff for appeal of denials; Conduct required follow-up on all initiated prior authorizations in an effort to obtain the final authorization Meet with transplant candidate, potential living donors and/or family to explain insurance coverage, treatment costs, and hospital billing policies Ensure that adequate insurance benefits or funding arrangements are in place prior to transplant. Consistently document all interactions with patients and family members Provide quality service to patients by providing comprehensive and ongoing financial counseling. Serves as a resource to transplant candidates and their families and living donors regarding transplant payor benefits, billing issues, alternative funding options, and personal financial responsibilities regarding the transplant. ABOUT UW MEDICAL CENTER-MONTLAKE: UW Medical Center is an acute care academic medical center located in Seattle with two campuses: Montlake and Northwest. As the No. 1 hospital in Seattle and Washington State since 2012 (U.S. News & World Report) and nationally ranked in seven specialties, UW Medical Center prides itself on compassionate patient care as well as its pioneering medical advances. The UW Medical Center-Montlake campus is located on the edge of the beautiful UW campus which includes many amenities available to our staff as well as very convenient public transit options including the Sound Transit’s light rail station across the street. Excellence. Exploration. Education. ABOUT UW MEDICINE – WHERE YOUR IMPACT GOES FURTHER UW Medicine is Washington’s only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals. All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored. Nearly 29,000 healthcare professionals, researchers, and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Medicine Primary Care, UW Physicians, UW School of Medicine, and Airlift

Requirements

High School diploma or GED certificate plus two years of experience in a medical office setting; OR, equivalent education/experience.

Responsibilities

Obtain and document detailed patient insurance benefit information for all phases of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and lodging, if necessary
Obtain all necessary authorizations from payers, verifying transplant coverage and other medical benefits and obtaining referrals and authorizations if required.
Request a Benefit Level Exception (BLE) or a Single Case Agreement (SCA) as appropriate from the UW Medicine Contracting Department for non-contracted health plans
Obtain all necessary information, including clinical documentation, required by payors for approval of different transplantation phases, including benefit verification, payor authorization, referrals, precertification, and case management
Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems; initiate communication with appropriate agencies and clinical staff for appeal of denials
Conduct required follow-up on all initiated prior authorizations in an effort to obtain the final authorization
Meet with transplant candidate, potential living donors and/or family to explain insurance coverage, treatment costs, and hospital billing policies
Ensure that adequate insurance benefits or funding arrangements are in place prior to transplant.
Consistently document all interactions with patients and family members
Provide quality service to patients by providing comprehensive and ongoing financial counseling.
Serves as a resource to transplant candidates and their families and living donors regarding transplant payor benefits, billing issues, alternative funding options, and personal financial responsibilities regarding the transplant.