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, precertifications, prior authorizations, and financial clearance throughout the pre- and post-transplant process. The coordinator works professionally with patients to explain financial obligations and identify ways to meet financial requirements, including assessing eligibility for financial assistance and insurance coverage, establishing payment arrangements, and collecting preservice payments and copayments as needed. The role may support workloads across all Mayo Clinic sites regardless of the employee’s physical location and may include pre-appointment insurance review and denials recovery functions within the Patient Access Prior Authorization department.

The position interprets insurance eligibility and transplant contracts, and submits Letter of Agreement and Individual Case Negotiation requests for in- or out-of-network coverage and self-pay issues. It may participate in transplant selection committee meetings, providing financial input to decisions about potential recipients and transplant listing status. The coordinator may also collaborate with multidisciplinary teams on transplant protocols and standards of care, and monitor and update documentation required by United Network of Organ Sharing guidelines, including listing, status changes, and post-transplant follow-up information. The role follows quality assurance guidelines and established productivity standards.

This is a hybrid position. The employee must live within 100 miles of a Mayo Clinic campus to meet on-site expectations based on business needs. The position is not eligible for visa sponsorship or transfer.

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.
• 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 applicable Federal Register rules and regulations for organ acquisition.

Responsibilities

• Resolve referrals, precertifications, prior authorizations, and financial clearance through pre- and post-transplant processes.
• Explain patients’ financial obligations and options for meeting financial requirements.
• Assess eligibility for financial assistance and insurance coverage, establish payment arrangements, and collect preservice payments and copayments as needed.
• Interpret insurance coverage eligibility and transplant contracts.
• Submit Letter of Agreement and Individual Case Negotiation requests to address in-network, out-of-network, or self-pay issues.
• Participate in transplant selection committee meetings and provide financial input regarding potential recipients and transplant listing status.
• Collaborate with multidisciplinary teams to develop and implement transplant patient protocols and standards of care.
• Monitor and update documentation under United Network of Organ Sharing guidelines, including listing, status changes, and post-transplant follow-up information.
• Adhere to quality assurance guidelines and established productivity standards.
• Potentially perform pre-appointment insurance review and denials recovery functions within the Patient Access Prior Authorization department.
• Potentially manage workload across all Mayo Clinic sites, regardless of physical location.

Benefits

• Medical insurance with multiple plan options.
• Dental coverage through Delta Dental or a reimbursement account for flexible coverage.
• Vision plan with a national network.
• HSA and FSAs for eligible expenses.
• Competitive retirement package.
• Continuing education and advancement opportunities.

What This Job Offers

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