Transplant Financial Advisor Lead

Transplant Financial Advisor LeadDays - Full TimeWestwood Medical Pavilion - West

Position Summary / Career Interest:

The Transplant Financial Advisor Lead serves as a subject matter expert and team lead for financial clearance and reimbursement activities related to complex cellular therapies, including stem cell transplant, CAR-T therapy, gene therapy, tumor-infiltrating lymphocyte (TIL) therapy, and high-cost oncology treatments. This position provides leadership, training, operational support, and escalation management while ensuring patients receive timely financial clearance and access to treatment.

The Transplant Financial Advisor Lead collaborates closely with physicians, clinical teams, pharmacy, authorization specialists, payors, patient access departments, and revenue cycle leadership to navigate complex insurance requirements, financial assistance programs, and self-pay arrangements. This role also supports departmental initiatives, workflow development, onboarding, and implementation of new projects and services.Responsibilities and Essential Job Functions

• Maintaining and reviewing therapies including all stem cell transplant, CAR-T, Gene, TIL, and high dollar-cost oncology treatments.
• Provide initial and ongoing training of employees. Sees that new employees are oriented to department and shift policies and procedures, and that all employees in appropriate classifications are cross trained to provide relief for absenteeism.
• Assists Supervisor with monitoring daily Work Queues consisting of all unsecured accounts. Following up with team members to meet Work Queue goals.
• Supports Patient Financial Advisors for questions and answers, directing them to proper policy and procedure or resources to accomplish the goals of the BMT Patient Advisor Team.
• Handle escalated patient concerns and complex financial clearance concerns
• Coordinates complex financial clearance cases with case management
• Oversees referrals to vendor and monitors Patient Financial Advisors Work Queues
• Contact the patient or family by phone or in person to ask them questions about sponsorship linkage. Includes health insurance, homeowner’s insurance, workman’s compensation insurance, pre-paid packages, grants, studies, COBRA, VA benefits, Crime Victim, auto insurance, Medicaid or Medicare. Comply with Medicare/Medicaid rules and regulations.
• Negotiates settlements or makes payment arrangements. If unable to make payments, then screens for partial or full charity, this includes completing the financial assessment application and obtaining all necessary documents. If the patient is uncooperative at any part of the screening process, their account(s) will be recommended for collections and ultimately bad debt.
• Works daily WQS consisting of all unsecured accounts. Requires taking appropriate actions necessary such as phone calls and written communication and using appropriate codes and timeframes.
• Serves as Liaison between the patient and family members and other health care personnel. Works with team members when patient / family interactions requiring financial support.
• Leads the team in the absence of the supervisor/manager or upon assignment.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• High School Graduate or GED.
• 5 or more years of experience in financial advising, claims processing, benefits explanation, cost estimates, benefit pricing, or patient accounting experience.

Preferred Education and Experience

• Associates Degree in Health Care Administration, Finance or a related field of study from an accredited college or university.
• 6 or more years of Epic experience.

Required Licensure and Certification

• Transplant Financial Advisor Certification within 6 months of hire

Knowledge Requirements

• CPT-4 and HCPCS coding knowledge
• Knowledge of Insurance (Commercial and Government)
• Familiarity with Payor websites
• Understanding of Transplant (BMT and/or Solid) procedures as it relates to coding and billing
• Working knowledge of CMS regulations

Time Type:

Full time

Job Requisition ID:

R-59442

Important information for you to know as you apply:

• The health system is an equal employment opportunity employer.  Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status.  See also Diversity, Equity & Inclusion.

• The health system provides reasonable accommodations to qualified individuals with disabilities.  If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link [email protected].

• Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

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