Transplant Financial Coordinator

at  RWJBarnabas Health

Req #: 0000168901
Category: Billing/Collections/Registration
Status: Full-Time
Shift: Day
Facility: RWJ New Brunswick
Department: Organ Transplants

JOB OVERVIEW:

The Transplant Financial Coordinator works with patients and their families beginning with the evaluation for transplantation and continuing through and after transplantation, in a compassionate and tactful manner, in order to help facilitate access to and provide continuity of care. This position is part of a multidisciplinary team charged with the responsibility of providing accurate and professional financial counseling to patients seeking transplant services.

QUALIFICATIONS:

Required:

• High school plus 4 years or more experience OR Associate College Degree plus 2 years of experience OR College degree with 1 year of experience
• Experience required in Hospital, Business Office, or Physician’s Office
• Must be able to effectively communicate with all levels of the organization
• Ability to analyze and update accounts via electronic systems

Preferred:

• experience in insurance review/verification and billing

SCHEDULING REQUIREMENTS:

• Day Shift - 8am to 4:30pm
• No weekends required
• Full-Time

ESSENTIAL FUNCTIONS:

• The Transplant Financial Coordinator (TFC) will work with other members of the transplant team, insurers, administrative, billing, financial and clinical personnel at RWJUH to ensure financial coverage of transplant and living donor services
• Participates in the weekly Transplant Selection Committee meetings to represent financial aspects of transplant candidates
• Prepares financial reports on each patient prior to the meeting, and answers questions about finances at the meeting
• Obtains and documents detailed patient insurance benefit information for all aspects of the transplant process, including, but not limited to, transplant surgery, outpatient prescription drugs, organ acquisition, follow-up clinic visits, and travel and housing if necessary
• Discusses benefits and other transplant financial issues with patients and/or family members during initial evaluation
• Advises patients on insurance and billing issues and options
• Serving as a resource for patients and their family members on financial matters
• Provides patients with educational materials about the financial considerations of transplantation and information about financing options and insurance coverage
• Obtains all necessary payor authorizations
• Verifies transplant coverage and other medical benefits and acquiring necessary referrals and authorizations for inpatient stays and procedures
• Monitors insurance coverage for patients throughout the period that they are waiting for a transplant
• Assists patients with questions concerning insurance and other financial issues
• Identifies and effectively communicates financial information to transplant team members, patients and their families with emphasis on identifying any potential patient out-of-pocket liability
• Works with patients, their families and team members, when possible, to help address insurance coverage gaps via alternative funding options
• Assists patients with the application process for government or other financial assistance programs working with the institution Financial Coordinators if a patient is self-pay or insurance benefits do not cover the hospital services
• Facilitates resolution of patient billing issues
• Serves as a liaison with the RWJUH professional fee and hospital billing offices to resolve billing questions and issues
• Communicates data to RWJUH Utilization Management Department to assist with the medical review process
• Collaborates with the RWJUH Office of Managed Care to obtain single case agreements, or other arrangements with patient insurance companies, in order facilitate transplant coverage
• Assists with proper identification of and accounting for global contract cases
• Maintains familiarity with UNOS and CMS regulations related to transplant finance and billing practices
• Assists with review of claims to determine if they are appropriate for payment from organ acquisition or by a patient’s insurance company

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.