Transplant Financial Coordinator - UWMC-Montlake Transplant Services
$52,208–$52,208 year
HybridSeattle, Washington, United States
Job Summary
Obtain and document detailed patient insurance benefit information for all transplant phases, including outpatient prescriptions, organ acquisition, and travel. Secure necessary payer authorizations, verify coverage, and request Benefit Level Exceptions or Single Case Agreements from the Contracting Department. Communicate payer request statuses, initiate appeals for denials, and conduct follow-up on prior authorizations. Meet with candidates, donors, and families to explain coverage, costs, and billing policies, ensuring adequate funding is in place before procedures. Provide comprehensive financial counseling and document all patient interactions.
Required Qualifications
- High School diploma or GED certificate
- Two years of experience in a medical office setting
- Ability to obtain and document detailed patient insurance benefit information
- Ability to obtain all necessary authorizations from payers
- Ability to verify transplant coverage and other medical benefits
- Ability to obtain referrals and authorizations
- Ability to request a Benefit Level Exception (BLE) or a Single Case Agreement (SCA)
- Ability to communicate with appropriate clinical staff regarding payer requests, denials, and potential denials
- Ability to initiate communication with appropriate agencies and clinical staff for appeal of denials
- Ability to conduct required follow-up on all initiated prior authorizations
- Ability to meet with transplant candidates, potential living donors, and/or family to explain insurance coverage, treatment costs, and hospital billing policies
- Ability to ensure that adequate insurance benefits or funding arrangements are in place prior to transplant
- Ability to consistently document all interactions with patients and family members
- Ability to provide quality service to patients by providing comprehensive and ongoing financial counseling
- Ability to serve as a resource to transplant candidates and their families and living donors regarding transplant payor benefits, billing issues, alternative funding options, and personal financial responsibilities regarding the transplant
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