VCU Health
Transplant Financial Coordinator - Massey Cancer Center - Days
VCU Health, Richmond, Virginia, United States, 23214
Overview
The Transplant Financial Coordinator is a designated member of the Hume-Lee solid organ transplant/VAD/TPIAT team or the Massey Cancer Center CIT/Bone Marrow Transplant team who is primarily responsible for coordinating, clarifying and managing patient specific financial aspects of care. The coordinator works with patients and their care teams from referral through evaluation for transplantation and continuing through and after transplantation to facilitate access to and understanding of the financial role of each phase of the transplant journey. The coordinator also collaborates with other team members, payers, administration, billing, financial and clinical personnel to ensure financial coverage of solid organ/VAD/TPIAT and living donor services.
Responsibilities
Essential Job Statements – Financial Services:
Manage the financial services and resources for solid organ transplant/VAD/TPIAT or CIT/Bone Marrow patients, including insurance coverage verification, identifying maximums for specialty services, and initiating referrals for fundraising, financial assistance or public benefit options. Communicate with patients about financial obligations (co-pays, fundraising, deposits); obtain and follow up on authorizations/pre-certifications for services and prescribed medications; provide estimated costs to patients as requested.
Performance Expectation – Communications:
Represent the center with internal and external groups regarding financial questions, policies, contracts, data reporting, and all aspects of transplant financial operations. Communicate with patients, families and/or guarantors about benefits, upcoming visits, and financial information through one-on-one discussions (in person or by phone) across all care phases.
Participate in the initial patient orientation and ongoing patient education on transplant/VAD/TPIAT needs, presenting financial information and clearance to the transplant/VAD/TPIAT team in multidisciplinary meetings and in weekly Patient Selection Meetings as well as ad-hoc collaborative meetings.
Ensure comprehensive communication to patients and families about potential out-of-pocket liability and post-care costs (medications, home health care) associated with services following surgery.
Coordinate with staff and third-party payers regarding patient financial issues; respond to inquiries within 3 business days and provide requested documentation.
Attend and participate in weekly division/department or program team meetings and provide additional information as requested.
Performance Expectation – Documentation & Reporting:
Establish procedures to ensure accurate and timely information flow for billing of services to recipients and living donors (including VAD and TPIAT candidates). Provide guidance on denials, appeals and managed care requirements in collaboration with the multidisciplinary team.
Performance Expectation – Coordination with Financial Resources:
Facilitate with revenue cycle and managed care partners to resolve complex billing issues, identify and resolve insurance billing edits and denials, and maintain quality assurance standards for medical records. Coordinate non-contracted health plans (including global transplant, VAD, TPIAT, CIT and Bone Marrow Transplant patients) when necessary.
Counsel and assist patients with fundraising options and patient assistance programs for medications, including insurance coverage options such as COBRA, Social Security Disability, Marketplace plans and Healthcare Exchange options.
Performance Expectation – Policies & Procedures:
Serve as the subject-matter expert on solid organ/VAD/TPIAT payer contracts, terms and bundles. Review, revise and maintain policies and procedures related to the Transplant Financial Coordinator role. Research and update all third-party payer policies related to billing and reimbursement. Maintain knowledge of regulatory requirements for transplant/VAD/TPIAT services (CMS, UNOS and other regulatory bodies; CMS Conditions of Participation as related to transplantation).
Performance Expectation – Administration:
Assist supervisor/team with mentoring and training of new staff. Attend regular staffing, workgroup and multidisciplinary team meetings.
Performance Expectation – Miscellaneous Responsibilities:
Perform other duties/projects as assigned by management, division/department or program staff, or administrator.
Patient Population Not applicable to this position
Employment Qualifications Required Education:
High School Diploma or equivalent. Combination of education and experience will be considered in lieu of a degree.
Preferred Education:
Coursework in medical terminology; Associate's or Bachelor’s degree in accounting, Finance, Business Administration, Healthcare Administration or closely related field.
Licensure/Certification Required:
Transplant Financial Coordinator Certification (within 18 months of hire).
Minimum Qualifications
Minimum of three (3) years of previous Registration, Healthcare insurance, Accounts Receivable, Billing and/or Collections experience in a healthcare setting.
Independent decision-making related to financial arrangements for transplant patients.
Cultural Responsiveness.
Preferred Qualifications:
Minimum of five (5) years of previous Registration, Healthcare insurance, Accounts Receivable, Billing and/or Collections experience in a healthcare setting.
Working Conditions Periods of high stress and fluctuating workloads may occur. General office environment. May have periods of constant interruptions. Prolonged periods of working alone.
Physical Requirements Physical Demands:
Lifting/ Carrying (0-50 lbs.).
Work Position:
Sitting, Walking, Standing.
Additional Physical Requirements/ Hazards:
Manual dexterity, shift work, maneuver weight of patients, hear alarms/telephone, reach above shoulder, repetitive arm/hand movements, finger dexterity, color vision, acuity – near/far.
Hazards:
Depth perception, use of latex gloves, exposure to dust/fumes, exposure to potential electrical shock, exposure to x-ray/electromagnetic energy.
Mental/Sensory – Emotional Mental/Sensory: Strong recall, reasoning, problem solving, hearing, clear speech, legible writing, reading, logical thinking. Emotional: fast-paced environment, ability to handle multiple priorities, frequent and intense customer interactions, ability to adapt to frequent change.
EEO
Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
#J-18808-Ljbffr
The Transplant Financial Coordinator is a designated member of the Hume-Lee solid organ transplant/VAD/TPIAT team or the Massey Cancer Center CIT/Bone Marrow Transplant team who is primarily responsible for coordinating, clarifying and managing patient specific financial aspects of care. The coordinator works with patients and their care teams from referral through evaluation for transplantation and continuing through and after transplantation to facilitate access to and understanding of the financial role of each phase of the transplant journey. The coordinator also collaborates with other team members, payers, administration, billing, financial and clinical personnel to ensure financial coverage of solid organ/VAD/TPIAT and living donor services.
Responsibilities
Essential Job Statements – Financial Services:
Manage the financial services and resources for solid organ transplant/VAD/TPIAT or CIT/Bone Marrow patients, including insurance coverage verification, identifying maximums for specialty services, and initiating referrals for fundraising, financial assistance or public benefit options. Communicate with patients about financial obligations (co-pays, fundraising, deposits); obtain and follow up on authorizations/pre-certifications for services and prescribed medications; provide estimated costs to patients as requested.
Performance Expectation – Communications:
Represent the center with internal and external groups regarding financial questions, policies, contracts, data reporting, and all aspects of transplant financial operations. Communicate with patients, families and/or guarantors about benefits, upcoming visits, and financial information through one-on-one discussions (in person or by phone) across all care phases.
Participate in the initial patient orientation and ongoing patient education on transplant/VAD/TPIAT needs, presenting financial information and clearance to the transplant/VAD/TPIAT team in multidisciplinary meetings and in weekly Patient Selection Meetings as well as ad-hoc collaborative meetings.
Ensure comprehensive communication to patients and families about potential out-of-pocket liability and post-care costs (medications, home health care) associated with services following surgery.
Coordinate with staff and third-party payers regarding patient financial issues; respond to inquiries within 3 business days and provide requested documentation.
Attend and participate in weekly division/department or program team meetings and provide additional information as requested.
Performance Expectation – Documentation & Reporting:
Establish procedures to ensure accurate and timely information flow for billing of services to recipients and living donors (including VAD and TPIAT candidates). Provide guidance on denials, appeals and managed care requirements in collaboration with the multidisciplinary team.
Performance Expectation – Coordination with Financial Resources:
Facilitate with revenue cycle and managed care partners to resolve complex billing issues, identify and resolve insurance billing edits and denials, and maintain quality assurance standards for medical records. Coordinate non-contracted health plans (including global transplant, VAD, TPIAT, CIT and Bone Marrow Transplant patients) when necessary.
Counsel and assist patients with fundraising options and patient assistance programs for medications, including insurance coverage options such as COBRA, Social Security Disability, Marketplace plans and Healthcare Exchange options.
Performance Expectation – Policies & Procedures:
Serve as the subject-matter expert on solid organ/VAD/TPIAT payer contracts, terms and bundles. Review, revise and maintain policies and procedures related to the Transplant Financial Coordinator role. Research and update all third-party payer policies related to billing and reimbursement. Maintain knowledge of regulatory requirements for transplant/VAD/TPIAT services (CMS, UNOS and other regulatory bodies; CMS Conditions of Participation as related to transplantation).
Performance Expectation – Administration:
Assist supervisor/team with mentoring and training of new staff. Attend regular staffing, workgroup and multidisciplinary team meetings.
Performance Expectation – Miscellaneous Responsibilities:
Perform other duties/projects as assigned by management, division/department or program staff, or administrator.
Patient Population Not applicable to this position
Employment Qualifications Required Education:
High School Diploma or equivalent. Combination of education and experience will be considered in lieu of a degree.
Preferred Education:
Coursework in medical terminology; Associate's or Bachelor’s degree in accounting, Finance, Business Administration, Healthcare Administration or closely related field.
Licensure/Certification Required:
Transplant Financial Coordinator Certification (within 18 months of hire).
Minimum Qualifications
Minimum of three (3) years of previous Registration, Healthcare insurance, Accounts Receivable, Billing and/or Collections experience in a healthcare setting.
Independent decision-making related to financial arrangements for transplant patients.
Cultural Responsiveness.
Preferred Qualifications:
Minimum of five (5) years of previous Registration, Healthcare insurance, Accounts Receivable, Billing and/or Collections experience in a healthcare setting.
Working Conditions Periods of high stress and fluctuating workloads may occur. General office environment. May have periods of constant interruptions. Prolonged periods of working alone.
Physical Requirements Physical Demands:
Lifting/ Carrying (0-50 lbs.).
Work Position:
Sitting, Walking, Standing.
Additional Physical Requirements/ Hazards:
Manual dexterity, shift work, maneuver weight of patients, hear alarms/telephone, reach above shoulder, repetitive arm/hand movements, finger dexterity, color vision, acuity – near/far.
Hazards:
Depth perception, use of latex gloves, exposure to dust/fumes, exposure to potential electrical shock, exposure to x-ray/electromagnetic energy.
Mental/Sensory – Emotional Mental/Sensory: Strong recall, reasoning, problem solving, hearing, clear speech, legible writing, reading, logical thinking. Emotional: fast-paced environment, ability to handle multiple priorities, frequent and intense customer interactions, ability to adapt to frequent change.
EEO
Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
#J-18808-Ljbffr