Transplant Financial Coordinator - Heart Acquisition

About This Role

The Transplant Financial Coordinator assures transplant patients' medical services are covered by insurance through verification, authorization, patient counseling, and understanding complex transplant benefits. This role involves real-time problem-solving and participation in team meetings to advance operational throughput and process improvement for patient care.

Responsibilities

• Coordinate and clarify patient-specific insurance and financial aspects of care with less than 5% inaccuracy
• Work with patients and their families to facilitate access to and continuity of care, addressing insurance and financial issues
• Obtain and document detailed patient insurance benefit information, limitations, and exclusions for transplant services
• Discuss benefits and transplant financial issues with patients and/or family members during initial evaluation and with insurance changes
• Obtain all necessary payor authorizations, approvals, and clearance, verifying transplant and other medical benefits
• Routinely monitor insurance coverage for patients throughout all phases of transplant, especially while waitlisted
• Identify and effectively communicate financial information to transplant team members and patients, focusing on potential liabilities and funding options
• Facilitate resolution of patient billing issues by liaising with USC Care and Keck billing offices
• Maintain familiarity with UNOS and CMS regulations related to transplant finance and billing practices
• Participate in weekly transplant selection committee meetings and multidisciplinary clinics to provide financial insurance expertise
• Engage non-contracted health plans and medical groups to secure LOAs or financial guarantees for transplant services

Requirements

• High school or equivalent
• Associate's degree in a related field (or 2 years transplant financial experience)
• Content knowledge of medical terminology and transplant process preferred
• Ability to become proficient in EMR and various IT systems
• Demonstrated ability to problem-solve and provide effective resolution

Qualifications

• High school or equivalent, Associate's degree in a related field
• 2 years transplant financial experience may substitute for minimum education. Preferred 2 years experience in the medical field, including transplant and transplant finance.

Nice to Have

• Bachelor's degree in a related field
• 2 years experience in the medical field, including transplant and transplant finance
• Bilingual, with certified department translator strongly preferred

Skills

* Required skills