Job Requirements
Responsibilities
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Interview transplant candidates to assess insurance coverage and eligibility for financial assistance programs
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Verify insurance benefits, process authorizations, and resolve coverage barriers including identifying alternative financial aid or charity programs
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Schedule inpatient and outpatient admissions; register patients and create hospital accounts for procedures and diagnostic tests
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Educate patients on insurance coverage, billing requirements, and self-pay responsibilities
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Maintain and update transplant database with authorization numbers, patient financials, and key billing information
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Develop and maintain financial reference guides including payer-specific policies, reimbursement guidelines, and state/federal regulations
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Communicate coverage issues to transplant clinical staff and collaborate to resolve
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Participate in transplant team meetings to present payer requirements and financial concerns
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Develop letters of medical necessity and respond to third-party payer requests for additional information
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Perform charge entry for national donor programs and ensure accurate billing across all transplant phases
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Complete billing attachments for managed care global contracts
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Maintain communication with Managed Care/Contracting to identify and process contract patients
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Develop and maintain workload volume reports as requested
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Serve as a resource for departments within and outside the Cancer Center or Transplant Center
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Cross cover for vacancies and assume additional workload as needed
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Performs other duties as assigned
Work Experience
Education & Experience
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High School Diploma or GED required
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Minimum 3 years of financial counseling experience in a hospital or healthcare setting
Knowledge, Skills & Abilities
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Knowledge of insurance verification and hospital registration systems
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EPIC experience preferred
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Strong written and verbal communication skills
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Proficient in word processing, database software, and basic computer operation
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Ability to serve diverse patient populations with understanding of growth and development across the lifespan
