Finance Specialist, Transplant, Full-Time, Days, 8:00am-4:30pm

Responsibilities

• Complete the Medicare Time Study Cost Report on alternating weeks on a monthly basis.
• Attend Committees/Support Groups as necessary, including but not limited to weekly Listing Committees specific to each organ, MELD score review meeting, Quality Committee meetings, and patients/families support groups.
• Be proficient in navigating OTTR.
• Perform various patient interviewing and fact-finding tasks upon registration, pre-admission, and collect or verify insurance and/or third-party information in order to assure funding and settlement of patient accounts.
• Perform financial screening and pre-registration, function as a point of contact.
• Determine the patient's financial responsibility and credit level and initiate collection process following Patient Access department protocol.
• Refers patients to the Department of Patient Financial Services for financial assessment and determination of eligibility, as needed.
• Prepare and ensure proper documentation of the patient's account package including designated hospital forms and copies of required documents.
• Ensure that the registration documents are scanned.
• Facilitate pre-certification and authorizations for designated payors prior to appointment.
• Accurately collect all pertinent demographic and funding information at point of contact.
• Complete cross-training to assist in other potential service departments.
• Stay abreast of new health care trends and maintain knowledge of various payors and third-party funding.
• Maintain patient appointment logs and/or productivity reports, as assigned.
• Maintain a working knowledge of basic medical terminology and inter-departmental functions.
• Maintain appropriate inter-departmental communications to enhance patient services.
• Input and retrieve data on a personal computer as needed.
• Respond promptly to patient inquiries and to telephone calls by the third ring.
• Communicate in a friendly, courteous and caring manner and promote the patient first philosophy at all times.
• Ensure the proper financial classification of patient accounts in accordance with established guidelines and make financial classification changes when warranted.
• Research any outstanding account balances for the patient and initiate collective efforts as necessary.
• Verify eligibility and authorizations from all third-party funding sources and obtain patient benefits.
• Develop third party funding and/or evaluate patients for referral to public medical assistance programs.
• Monitor and work the accounts receivable according to Patient Financial Services guidelines and contractual agreements.
• Absorb and respond to billing inquiries, as necessary.
• Perform charge entry, patient check in and check out as applicable.
• Obtain and verify detailed patient insurance benefit coverage for all phases of the transplant process; and assist in acquiring the necessary referrals and authorizations.
• Review benefit and other transplant financial issues with patients or family members during the initial evaluation; including, advising patients insurance and billing issues and available options.
• Serve as a patient financial liaison for patients and their families; includes assisting patients with questions concerning insurance and financial issues.
• Monitor and update patient financial and demographic information regarding insurance, physicians, authorizations, and preferred providers.
• Effectively communicate financial information to transplant team members, patients, and their families with an emphasis on identifying potential out of pocket expenses and addressing insurance coverage gaps.
• Facilitate resolution of patient billing issues.
• Demonstrate behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).

Qualifications

• Generally requires 3 to 5 years of related experience.
• High School diploma is required.
• Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
• Ability to communicate effectively in both oral and written form.
• Ability to handle difficult and stressful situations with critical thinking and professional composure.
• Ability to understand and follow instructions.
• Ability to exercise sound and independent judgment.
• Knowledge and skill in use of job appropriate technology and software applications.
• Valid license or certification is required as needed, based on the job or specialty.