Transplant Financial Coord-Cell Therapy and Transplant Hybrid

The Transplant Financial Coordinator is responsible for evaluating patient insurance coverage and provide pre-certification for various stages of the transplant event. Provide information necessary to obtain prior authorization for transplant and donor related services to insurance and medical review companies. Serve as liaison for division and insurance carriers to ensure proper billing and authorization are obtained in a timely manner. Oversee and facilitate patient access and flow through the BMT transplant program. Assist program administrator with organization and completion of documents describing program activity for health system administration and outside agencies. This positon has a hybrid schedule.

• Responsibilities:

  • Identifies and effectively communicates financial information to cell therapy and transplant team members, patients and their families with emphasis on identifying any potential patient out-of-pocket liability. Establishes relationships with insurance company case managers and medical directors to facilitate insurance approvals.
  • Obtains all necessary payor authorizations. Verifies cell therapy infusion coverage and other medical benefits and acquiring necessary referrals and authorizations for inpatient stays and procedures. Works with patients, their families and team members when possible to help identify insurance coverage gaps.
  • Facilitates resolution of patient billing issues. Serves as a liaison with the professional fee and hospital billing offices to resolve billing questions and issues.
  • Obtains and documents detailed patient insurance benefit information for all aspects of the cell therapy and transplant process, including, but not limited to, stem cell collection, donor search and cell acquisition, inpatient transplant admission, CART infusions.
  • Collaborates with the Managed Care Department to obtain single case agreements, or other arrangements with patient insurance companies, in order facilitate transplant coverage.
  • Assists hospital claims department with proper identification of and accounting for global contract cases.

   

  Credentials:

  Education or Equivalent Experience:

  • H.S. Diploma/GED (Required)
  • Prefer associate degree or someone working towards a degree. Requires course level training in Medical Terminology. Must have at minimum 3 years medical billing experience working with carriers. Certified Coder a plus. Experience in Customer Service.