Transplant Financial Coordinator

WVU Medicine•Morgantown, WV

22h•Onsite

About The Position

The Transplant Financial Coordinator is an advanced level position, responsible for resolving referral, precertification, prior authorization, and financial clearance beginning with the evaluation for transplantation and continuing through the post-transplant process. This includes participation and collaboration with a multidisciplinary team in the development and implementation of protocol and standards of care planned for the transplant patient. Assist in transplant financial vitality by reviewing accounts to ensure appropriate billing for transplant related services. Courteously and professionally work with patients to outline financial obligations related to care, and provide options for patients to meet financial requirements, including assessing financial assistance eligibility, determining insurance coverage eligibility, establishing payment arrangements, collecting preservice payments and co-payments as needed.

Requirements

High school diploma or equivalent
Five (5) years of healthcare finance experience or bachelor’s degree with three (3) years of healthcare finance experience.
CRCR certification through Healthcare Financial Management Association (HFMA
Transplant Financial Coordinators Association (TFCA) membership.
Excellent written and communication skills
Oral and written communication ability to effectively represent the department and Hospital in interactions with third party payers, patients, physicians, and other departments. Ability to explain this analysis to a non-technical audience of both internal and external customers, including executive management.
Analytical and problem-solving skills as well as the ability to work and communicate effectively with other departments.
Ability to manage multiple tasks and projects in a fast-paced environment and forge strong interpersonal relationships within the department and with other departments
Ability to work independently on projects and add measurable value to the organization.
Extensive knowledge of personal computers and Microsoft Excel and Access software preferred.
Demonstrates knowledge of third-party payer regulations, revenue cycle functions, and electronic health records requirements.
Maintains current knowledge of performance improvement processes as it applies to health care.

Nice To Haves

Bachelor’s degree in business, health information, or related field
Five (5) years of financial counseling experience
Revenue cycle experience

Responsibilities

Verify detailed patient insurance benefit information for all aspects of the transplant process, including but not limited to outpatient prescription drugs, living donor coverage, follow-up clinic visits, and travel/lodging if necessary.
Evaluate insurance status and determine whether COBRA insurance benefits or other financial resources will maximize reimbursement.
Identify and effectively communicate any potential out-of-pocket liability to patients and/or their family.
Contact commercial insurance companies to verify benefits and obtain prior authorization for transplant services.
Contact government insurance agencies to verify benefits and obtain prior authorization for transplant services.
Provide fund-raising information to patients regarding local and national fund-raising organizations.
Maintain membership with the National Transplant Financial Coordinators Association to receive updates on new transplant laws.
Determine and assess if patients’ medical services are transplant related and how benefits should be paid.
Review account claim errors pre-billing related to registration for all transplant related account to review for coordination of benefits, payer, and patient demographic accuracy to ensure prompt payment.
Review all self-pay donor statements to ensure correct billing to maintain Medicare regulation compliance.
Attend weekly departmental transplant meetings to discuss current and potential transplant patients.
Project a mature problem-solving response while dealing with interpersonal conflict, medically compromised individuals, dissatisfied patients, and stringent time demands.