Transplant Financial Coordinator, Cardiac Recovery Room

at  RWJBarnabas Health

JOB OVERVIEW:

The Transplant Financial Coordinator is responsible for providing accurate and timely financial clearance for patients seeking advanced therapies for heart failure, transplant and VAD services. The TFC works with patients and their families from evaluation through post- transplantation in a compassionate and tactful manner in order to help facilitate access to and provide continuity of care.

QUALIFICATIONS:

Required:

• High school diploma or G.E.D. equivalent
• General knowledge base of billing requirements and rules
• Comprehensive knowledge of insurance coverage generally obtained through three (3) or more years of relevant experience, preferably in a hospital setting
• Extensive knowledge of various insurance coverage, COB rules of priority and processing procedures
• Organizational and time management skills required in order to maintain and prioritize daily work, weekly reports and to follow-up on accounts in a timely manner
• Ability to work in self-directed environments
• Must have a good grasp of medical terminology
• Excellent communication and customer service skills required

Preferred:

• Associates degree is preferred
• Understanding of Medicare and Medicaid regulations and rules with a background in coordination of benefits, preferred

SCHEDULING REQUIREMENTS:

• Shift- 8:30am 4:30pm
• Monday- Friday
• Full Time

• Obtains and verifies, detailed patient insurance benefit information, including but not limited to, outpatient prescription drugs, organ acquisition, follow-up clinic visits, and travel and housing if necessary
• Discusses insurance issues and completes a financial review with patients and family members during the initial evaluation
• Serves as a resource for patients and family members on financial matters throughout the transplant/donation process
• Works with insurers to verify coverage and obtain payor authorizations for transplant related services
• Maintains a working knowledge of all policies, procedures and criteria for all contracted managed care organizations
• Completes and submits all Requests for Information (RFI) from insurance carriers and/or managed care companies
• In collaboration with Organ Transplant Social Worker, develops a plan to address patient insurance coverage gaps via alternative funding options.
• Manages the process of recipient insurance data and authorization to communicate relative information to the Transplant Team members as appropriate throughout the transplant/donation process and during Selection Committee