Full-Time
Transplant Financial Coordinator
Liver Acquisition
University of Southern California
Research university in Los Angeles, CA
Compensation Overview
$29 - $45.20/hr
Los Angeles, CA, USA
In Person
Associate's
Category
 Finance & Banking (1) |
|---|
Required Skills
HIPAA
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Requirements
- A high school diploma or equivalent is required.
- An Associate's degree is required, or equivalent experience consisting of at least two years of transplant financial coordination.
- At least two years of financial coordination experience is required, preferably in transplant financial coordination.
- Broad knowledge of health insurance terminology, health insurance processes, and the transplant process is required.
- Knowledge of the transplant database OTTR, electronic medical records, and various information technology systems is required.
- Demonstrated ability to problem-solve and provide effective resolution is required.
- Fire Life Safety Training for the City of Los Angeles is required; if not held upon hire, it must be obtained within 30 days and renewed before expiration.
Responsibilities
- Lead, mentor, and provide professional guidance to transplant financial staff, including helping organize daily tasks and resolve challenging financial clearance scenarios.
- Coordinate and clarify patient-specific insurance and financial aspects of care, obtain and document detailed insurance benefit information, and determine appropriateness for transplantation services and program financial criteria.
- Discuss transplant benefits and financial issues with patients and family members during initial evaluation and when insurance coverage changes.
- Serve as a resource for patients and family members on financial and insurance matters and provide education about transplant financial benefits, coverage options, insurance types, and potential pitfalls.
- Guide patients through applications for government-funded and financial assistance programs, including Medi-Cal, the KMC charity program, Qualified Medicare Beneficiary, Legal Aid, and the Low Income Subsidy, and coordinate benefits as necessary.
- Work with transplant team members, administrative staff, billing, financial, and clinical personnel to ensure financial coverage of transplant and living donor services.
- Identify and communicate potential out-of-pocket liability, clearance issues, coverage gaps, and alternate funding options to transplant team members, patients, and families.
- Maintain familiarity with United Network for Organ Sharing and Centers for Medicare & Medicaid Services regulations related to transplant finance and billing practices, and follow applicable institutional and transplant institute policies and procedures.
- Coordinate recipient and living donor benefits, financial clearance, authorizations, planned surgical events, and insurance issue resolution with clinical staff.
- Obtain necessary payor authorizations, approvals, referrals, and clearance; verify transplant coverage and medical benefits; and assist with urgent inpatient transfers and critical or acute care clearance.
- Monitor insurance coverage throughout all phases of transplantation, particularly while patients are waitlisted, and cultivate relationships with insurance case managers and medical directors to expedite authorization approvals.
- Retrieve clinical data in a timely manner when requested or required by third-party payors.
- Facilitate resolution of patient billing issues and liaise with USC Care, Keck billing offices, non-contracted health plans, medical groups, and contracting departments to obtain letters of agreement or other financial guarantees.
- Participate in weekly transplant selection committee meetings and multidisciplinary clinics to provide financial insurance expertise and prepare patient financial reports for decision-making.
- Maintain HIPAA compliance by protecting patient information, confirming patient identifiers and authorized representatives, and reporting violations through the required channels.
- Provide professional customer service when interacting with patients, peers, physicians, supervisors, hospital personnel, and leadership.
- Perform other duties as assigned.
Desired Qualifications
- Bilingual ability is strongly preferred.
- Certification as a Certified Transplant Financial Coordinator is strongly preferred.
The University of Southern California is a private research university with academic programs across the arts, sciences, business, engineering, law, health, and other professional fields.
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