Transplant Financial Liaison

Northwestern Memorial Healthcare•Chicago, IL

5d•$24 - $36•Onsite

About The Position

The Transplant Financial Liaison reflects the mission, vision, and values of Northwestern Memorial, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. This position ensures continuity of admitting, registration, billing, collections, and other services through expertise in and across specific disciplines for third party payers, contracted vendors, and designated hospital programs.

Requirements

Experience in Revenue Cycle or Patient Access.
Associate Degree or equivalent work experience.

Nice To Haves

Experience in Epic HB and PB Billing.
Experience in Transplant Billing or Transplant Clinical applications
Understanding of Transplant contracts.

Responsibilities

Interviews potential Kidney and Liver Transplant candidates: gathers pertinent demographic and insurance information.
Reviews all new kidney patient files for benefit exclusions and limitations.
Monitors all information being sent to patients and insurance companies.
Reviews and corrects all new liver registrations.
Verifies transplant insurance benefits for primary and Secondary carriers for Kidney and Liver Transplant candidates.
Identifies transplant benefits for both the hospital and professional components related to the transplant services, potential limitations and pre-certification requirements.
Evaluates expected reimbursement to minimize financial risk of the programs including evaluating and communicating with patients potential financial responsibilities.
Weekly registration for all new Liver candidates.
Follow up calls for all pending Kidney transplant cases.
Performs pre-certification as required for evaluation, transplant and post-transplant services.
Performs pre-certification of all Access and Elective surgeries.
Consults with patient's donors regarding transplant coverage.
Discuss with donor the necessity of all bills coming to the transplant facility.
Collaborates with the billing team concerning any patient or insurance issues.
Collaborates with payer Case Managers concerning potential transplant patients listed or not listed and update of clinical status.
Collaborates with Managed Care in developing and obtaining single case rate letters for foreign nationals as well as all self-pay patients.
Reviews NMFF patient information forms and files copies in pre-liver patient files.
Coordinates with the Medical Center pharmacy the take home medications for patients who are either donors or have a single case agreement.
Reviews and monitors all CMH donor patient accounts.
Participates in Kidney Educational meetings.
Participates in Kidney and Kidney, Pancreas and Liver multi-disciplinary meetings.
Performs yearly transplant insurance audit mail out.
Mails out or faxes all clinical information to payers.
Supplies all insurance information to NMFF for billing.
Reviews Consent forms and checks for current status including signature, date, and timeliness.
Reports on activities, issues, and any action items to management and staff.
Ensures responses to patient and customer inquiries, providing feedback to suppliers and providing assistance to others performed completely, accurately, and within the time frames defined within division standards, objectives, and goals.
Completes other duties as assigned by director or manager.
Meets or exceeds departmental, divisional, and institutional goals.
Adheres to NMH, divisional and departmental quality standards.
Identifies opportunities for and participates in process improvement activities.