Transplant Finance Coordinator Job in Baltimore, Maryland US
Transplant Finance Coordinator
TRANSPLANT FINANCE COORDINATOR Requisition Number: 35478 Department: Finance Schedule: Full Time Shift: Day Hours: 8:30am-5pm Work Location: Admin 304 Job Details: - Bachelor's POSITION SUMMARY: The Transplant Finance Coordinator serves as the primary point of contact for the Departments of Surgery and Pediatrics and patients with respect to determining third party coverage for transplant-related services, including solid organ and bone marrow transplantations.-, related clinical trial's and investigational devices, and investigational and off label use of Pharmaceuticals. Informs and educates third party payers on waiting list protocols; updates insurance and financial information for patients currently on the waiting list; ensures that all authorization/certification requirements are completed in accordance with the payer's review criteria. Negotiates coverage and approvals with third party payers, as needed. Requests physician assistance for those cases denied coverage for medical appropriateness. Disseminates authorization documents to appropriate department and hospital staff. Keeps administrative staff and physicians informed throughout the approval process. Generates third party claims and pursues insurers for payment of all transplant-related services. Recommends accounts for alternative funding or, collection agency placements in rare circumstances. COMPETENCIES: A. Education: . Requires knowledge of accounting, finance and statistics principles as normally acquired through completion of a Degree in Accounting, Business Administration or a related field. B. Knowledge: . Requires some familiarity with the Maryland reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues. . Requires detailed knowledge of coverage issues affecting transplant services for all major payer groups. . Requires basic knowledge of accounting principles that directly impact the accounts receivable, including debit and credit transactions; charge transfers; contractual allowances and adjustments; financial class changes. . Requires detailed knowledge of JHHS financial and billing policies and procedures, including managed care authorization and pre-certification requirements. . Requires knowledge of Federal and State Regulatory controls and how they impact these programs. . Requires knowledge of medical terminology. . Requires knowledge of standard PC word processing and spreadsheet applications. C. Skills: . Requires excellent interpersonal skills to communicate effectively with clinicians, patients and third party payers. . Must be able to verbalize complex financial information and clinical treatment plans to a variety of professional staff and patients. . Requires use of persuasive techniques in writing letters to insurers and patients regarding detailed and complicated issues and in telephoning payers and review agents to negotiate coverage for these services. . Requires excellent