Transplant Financial Coordinator - Transplant Administration - 8010 Frost Street - Day - Full Time

Hours : Shift Start Time: 8 AM Shift End Time: 4:30 PM AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $26.970 - $33.730 - $37.770 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.   What You Will Do The Transplant Financial Coordinator plays an integral role in assisting patients with the critical function of financial planning for their transplant surgery, VAD implant, and future medical needs as well as assuring transplant department billing compliance. The primary responsibility of the Transplant Financial Coordinator is assessing patient's insurance coverage and financial situation for transplantation and immunosuppressant drug coverage. The Transplant Financial Coordinator is also a key member of the transplant program and must provide up to date and accurate input on patient financial clearance for transplantation and VAD implants during department staff meetings, selection meetings, huddles, etc. Required Qualifications H.S. Diploma or Equivalent 5 Years Experience in medical billing (hospital and/or professional), processing financial transactions and/or finance related field Preferred Qualifications Associate's Degree Transplant financial counseling and billing experience. Essential Functions Customer Service Serves as an exemplary customer service role model by demonstrating a positive, caring attitude to all patients, guests, fellow Sharp HealthCare employees, external contacts, and physicians while promoting teamwork in the accomplishment of Department and Hospital goals. Assists Team Leader with staff development in customer relations by increasing employee awareness when areas for improvement are observed. Identifies and recommends methods that would improve existing service and opportunities for service recovery. Meets with transplant candidate, potential living donors and/or family to explain insurance coverage, treatment costs, and hospital billing policies. Ensures that adequate insurance benefits or funding arrangements are in place prior to transplant. Consistently document all interactions with patients and family members. Provides quality service to patients by providing comprehensive and ongoing financial counseling. Serves as a resource to transplant candidates and their families and living donors regarding transplant payor benefits, billing issues, alternative funding options, and personal financial responsibilities regarding the transplant. Assists transplant candidates in meeting expenses for transplants by providing guidance on fundraising, completion of Medicare/Medicaid/disability applicants, indigent funding, etc. Perform post-transplant billing counseling services to patients, including discussion of benefits and financial concerns. Confirm patient post-transplant insurance coverage, obtain, verify, and update insurance, financial, statistical, and demographic information. Demonstrates Flexibility and Adaptability Is at workstation, ready to work, from scheduled start time through end of shift, except for designated breaks. Assists in other finance transplant areas to relieve temporary backlogs in work flow. Accepts new assignments, changing workloads, schedule changes, and/or deviations from standard work days with a positive attitude, assisting with the smooth transition and/or implementation of new and existing procedures. Prepare and attend transplant selection committee meeting; present and discuss financial issues pertaining to patients that are being presented for transplant listing and surgeries. Complete all other job duties as assigned by direct management. Leadership Performs all functions of a Transplant Financial Coordinator in a manner that demonstrates exceptional understanding and proficiency. Functions include: * Obtains and documents detailed patient insurance benefit information for all phases of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and lodging, if necessary. * Obtains all necessary authorizations from payers. Verifying transplant coverage and other medical benefits and obtaining referrals and authorizations if required * Obtains all necessary information, including clinical documentation, required by payors for approval of different transplantation phases, including benefit verification, payor authorization, referrals, precertification, and case management. * Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems; initiate communication with appropriate agencies and clinical staff for appeal of denials; Conduct required follow-up on all initiated prior authorizations in an effort to obtain the final authorization. * Verifies the accuracy and completeness of relevant financial, insurance, and or demographic information for transplant related outpatient encounters and the inpatient transplant admission to ensure that accounts are secure prior to discharge. * Complete Inpatient admission notification for urgent or planned admissions. Coordinate with the Utilization Management department to facilitate patient admission/discharge information to fulfill insurance carrier requirements. * Establishes and maintains a working relationship with key contacts at insurance companies (i.e., case managers, medical directors). * Collaborate with clinical team to communicate changes in pre-authorization, denial