Transplant Financial Coordinator

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Below, you’ll find other important information about this 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.

EDUCATION, CERTIFICATION, AND/OR

1. High school diploma or equivalent

1. Five (5) years of healthcare finance experience or bachelor’s degree with three (3) years of healthcare finance experience. To be completed as established by department: (Administered at Department level) 1.

CRCR certification through Healthcare Financial Management Association (HFMA. 2. Transplant Financial Coordinators Association (TFCA) membership.

EDUCATION, CERTIFICATION, AND/OR

1. Bachelor’s degree in business, health information, or related field

1. Five (5) years of financial counseling experience 2. Revenue cycle experience CORE DUTIES AND

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1.

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. 2. Evaluate insurance status and determine whether COBRA insurance benefits or other financial resources will maximize reimbursement. 3. Identify and effectively communicate any potential out-of-pocket liability to patients and/or their family. 4.

Contact commercial insurance companies to verify benefits and obtain prior authorization for transplant services. 5. Contact government insurance agencies to verify benefits and obtain prior authorization for transplant services. 6. Provide fund-raising information to patients regarding local and national fund-raising organizations. 7.

Maintain membership with the National Transplant Financial Coordinators Association to receive updates on new transplant laws. 8. Determine and assess if patients’ medical services are transplant related and how benefits should be paid. 9. 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. 10.

Review all self-pay donor statements to ensure correct billing to maintain Medicare regulation compliance. 11. Attend weekly departmental transplant meetings to discuss current and potential transplant patients. 12. Project a mature problem-solving response while dealing with interpersonal conflict, medically compromised individuals, dissatisfied patients, and stringent time demands.

PHYSICAL

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the

. 1. Ability to sit for long periods of time. 2. Ability to lift, push or pull 10–15 pounds.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the

. 1. Standard office/clinic environment. SKILLS AND ABILITIES: 1.

Excellent written and communication skills 2. 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. 3.

Analytical and problem-solving skills as well as the ability to work and communicate effectively with other departments. 4. Ability to manage multiple tasks and projects in a fast-paced environment and forge strong interpersonal relationships within the department and with other departments 5. Ability to work independently on projects and add measurable value to the organization. 6.

Extensive knowledge of personal computers and Microsoft Excel and Access software preferred. 7. Demonstrates knowledge of third-party payer regulations, revenue cycle functions, and electronic health records requirements. 9. Maintains current knowledge of performance improvement processes as it applies to health care.

Additional

Scheduled Weekly Hours: 40

Exempt/Non-Exempt: United States of America (Non-Exempt) Company: WVUH West Virginia University Hospitals Cost Center: 7850 WVUH Transplant Admin Morgantown West Virginia Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law.

All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.