MUSC Health
Transplant Financial Coordinator
MUSC Health, Charleston, South Carolina, United States, 29408
Overview
Join to apply for the
Transplant Financial Coordinator
role at
MUSC Health . The Transplant Financial Coordinator (TFC) provides analysis, validation, regulatory and compliance activities related to coordinating financial aspects of care for adult and pediatric transplant candidates, donors, and their families. The TFC mitigates financial risk by performing accurate financial clearance reviews and comprehensive analyses of patient and payor benefits and patient liability. The role involves coordinating financial aspects of care, conducting financial screening assessments, and serving as a liaison among transplant candidates, the transplant center, and insurance payors. The TFC acts as a subject matter expert on complex contracts, payor requirements, CMS coverage regulations, related billing practices, and governing transplant regulations and policies for solid organ transplantation. The TFC advises patients on insurance benefits and prior authorization/referral requirements, and serves as a resource to patients, families, clinical staff, physicians, MUSC’s managed care, billing teams and insurance companies. The role includes making administrative/financial clearance decisions to list a patient for solid organ transplantation. The TFC also participates in a multidisciplinary team to provide accurate financial evaluations and analyses, determine financial risk for MUSC, transplant physicians, and patients, and secure required authorizations for hospital and physician services. The position utilizes Epic, Excel, and external databases to analyze and facilitate efficient processing of claim reimbursement, ensures accuracy of financial charges and reimbursement, and communicates between payors and MUSC for proper billing and reimbursement. Responsibilities
Perform analysis, validation, regulatory and compliance activities related to financial aspects of care for adult and pediatric transplant candidates, donors, and families. Conduct financial clearance reviews and comprehensive analyses of patient and payor benefits and patient liability. Coordinate financial aspects of care, conduct financial screening assessments, and act as a liaison among candidates, transplant center, and insurance payors. Serve as a subject matter expert on complex contracts, payor requirements, CMS coverage regulations, billing practices, and transplant regulations. Advise patients on solid organ insurance benefits and prior authorization/referral requirements; operate as a resource to patients, families, clinical staff, physicians, managed care, billing teams and insurers. Make administrative/financial clearance decisions to list a patient for transplantation. Provide financial evaluations and analysis to determine financial risk and ensure appropriate communications between payors and MUSC for billing and reimbursement. Utilize Epic, Excel, and external databases to analyze and facilitate claim reimbursement; ensure accuracy of charges and reimbursement. Qualifications
Bachelor degree from an accredited university and two years of healthcare experience or high school diploma and 5 years of job experience in referral management, oncology navigation or patient access. Knowledge of complex medical terminology; strong interpersonal, organizational, verbal and written communication skills; ability to establish collaborative relationships; ability to prioritize and multi-task; autonomous work style and teamwork capability; critical-thinking skills. Ability to work with autonomous decision-making in coordinating insurance benefit information, authorization, billing and collections for transplant services. Experience using Epic, Excel; ability to obtain inpatient/outpatient authorizations and ensure accurate billing and reimbursement. Additional Job Description:
Includes the above responsibilities plus the requirement of providing a comprehensive overview of benefits for pre-transplant maintenance and transplant admission, obtaining necessary authorizations, and ensuring clear communication between payors and MUSC. Equal Employment Opportunity:
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based on qualifications, merit and business need. MUSC participates in the federal E-Verify program to confirm identity and employment authorization. For information about E-Verify, visit the official USCIS site.
#J-18808-Ljbffr
Join to apply for the
Transplant Financial Coordinator
role at
MUSC Health . The Transplant Financial Coordinator (TFC) provides analysis, validation, regulatory and compliance activities related to coordinating financial aspects of care for adult and pediatric transplant candidates, donors, and their families. The TFC mitigates financial risk by performing accurate financial clearance reviews and comprehensive analyses of patient and payor benefits and patient liability. The role involves coordinating financial aspects of care, conducting financial screening assessments, and serving as a liaison among transplant candidates, the transplant center, and insurance payors. The TFC acts as a subject matter expert on complex contracts, payor requirements, CMS coverage regulations, related billing practices, and governing transplant regulations and policies for solid organ transplantation. The TFC advises patients on insurance benefits and prior authorization/referral requirements, and serves as a resource to patients, families, clinical staff, physicians, MUSC’s managed care, billing teams and insurance companies. The role includes making administrative/financial clearance decisions to list a patient for solid organ transplantation. The TFC also participates in a multidisciplinary team to provide accurate financial evaluations and analyses, determine financial risk for MUSC, transplant physicians, and patients, and secure required authorizations for hospital and physician services. The position utilizes Epic, Excel, and external databases to analyze and facilitate efficient processing of claim reimbursement, ensures accuracy of financial charges and reimbursement, and communicates between payors and MUSC for proper billing and reimbursement. Responsibilities
Perform analysis, validation, regulatory and compliance activities related to financial aspects of care for adult and pediatric transplant candidates, donors, and families. Conduct financial clearance reviews and comprehensive analyses of patient and payor benefits and patient liability. Coordinate financial aspects of care, conduct financial screening assessments, and act as a liaison among candidates, transplant center, and insurance payors. Serve as a subject matter expert on complex contracts, payor requirements, CMS coverage regulations, billing practices, and transplant regulations. Advise patients on solid organ insurance benefits and prior authorization/referral requirements; operate as a resource to patients, families, clinical staff, physicians, managed care, billing teams and insurers. Make administrative/financial clearance decisions to list a patient for transplantation. Provide financial evaluations and analysis to determine financial risk and ensure appropriate communications between payors and MUSC for billing and reimbursement. Utilize Epic, Excel, and external databases to analyze and facilitate claim reimbursement; ensure accuracy of charges and reimbursement. Qualifications
Bachelor degree from an accredited university and two years of healthcare experience or high school diploma and 5 years of job experience in referral management, oncology navigation or patient access. Knowledge of complex medical terminology; strong interpersonal, organizational, verbal and written communication skills; ability to establish collaborative relationships; ability to prioritize and multi-task; autonomous work style and teamwork capability; critical-thinking skills. Ability to work with autonomous decision-making in coordinating insurance benefit information, authorization, billing and collections for transplant services. Experience using Epic, Excel; ability to obtain inpatient/outpatient authorizations and ensure accurate billing and reimbursement. Additional Job Description:
Includes the above responsibilities plus the requirement of providing a comprehensive overview of benefits for pre-transplant maintenance and transplant admission, obtaining necessary authorizations, and ensuring clear communication between payors and MUSC. Equal Employment Opportunity:
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based on qualifications, merit and business need. MUSC participates in the federal E-Verify program to confirm identity and employment authorization. For information about E-Verify, visit the official USCIS site.
#J-18808-Ljbffr