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Transplant Accounts Clerk/UKHC

4 months ago

Lexington, Kentucky, United States University of Kentucky Full time
Posting Details
Posting Details

Job Title
Transplant Accounts Clerk/UKHC

Requisition Number
RE43031

Working Title
Transplant Financial Counselor (Remote)

Department Name

H3420:
Transplant

Work Location
Lexington, KY

Grade Level
07

Salary Range
$ /hour

Type of Position
Staff

Position Time Status
Full-Time

Required Education

AA

Click here for more information about equivalencies:
Required Related Experience

3 yrs

Required License/Registration/Certification
None

Physical Requirements

The physical requirements of this position include: occasionally lifting, pushing, and/or pulling objects up to 50lbs; occasionally standing or walking with objects up to 10lbs; regularly sitting at a computer workstation for extended periods of time with regular repetitive motions (such as typing); occasionally dealing with combative/violent people; and occasional job-related travel (< 10% of the time).

Shift
Days; Monday through Friday. This is a fully remote position.

Job Summary
This position is absolutely essential in the Transplant Center's ability to receive reimbursement for a patient's outpatient, diagnostic and inpatient services either from a third party payer source of the patient, while remaining in compliance with UNOS by-laws and regulations

Job responsibilities include:
Maintains active authorizations for transplant patients on UNOS waitlist. Research and ensure active authorizations for 500+ patients each month. Determines the extent of liability for insurance plans, coordinates benefits and personal responsibility, communicating with the team and patient.

Ability to analyze and update accounts according to specific standards and guidelines and sustain a knowledge base applicable to ongoing changes within the insurance realm.

Initiate insurance authorization on all new patient referrals. Obtain detailed benefit information for all referred patients relating to transplant, pharmacy benefits, and ancillary testing. Ensures and interprets insurance group's pre-certification requirements and completes on-line operations for specific payers to complete the pre-certification process. Develops individual patient contracts by partnering with Managed Care Finance. Collaborates with nursing team to submit clinical information as required by insurance groups. Customer service, acts as the patient advocate with the patient and/or family and liaison with insurance companies. Conducts face to face interviews and advises patient with regards to next steps or processes for securing financial coverage. Assist patient and/or guarantor in obtaining other resources (i.e. Medicaid, pharmacy assistance programs, etc.) Refer to Chamberlin Edmonds as needed. Collaborate with social work as needed. Partners with financial accounts and KMSF as needed to resolve patient questions and/or billing inquiries.

Hosts managed care organizations, partnering with Managed Care Finance, for on-site visits and reviews to ensure continued participation in networks.

Aligns patient services and data reporting with all regulatory requirements. Serves as active participant in weekly multi-disciplinary committee per UNOS and CMS requirements. Responsible for communicating to the committee regarding patient eligibility for UNOS listing. Document all financial clearance letters, patient interactions, and patient teaching in the transplant tracking database, OTTR.

After a transplant is completed, collect and document all required data into internal files for use in monthly data and quarterly scorecards.

Skills / Knowledge / Abilities

The ideal candidate will possess excellent attention to detail; exceptional planning and organizational skill; effective written and verbal communication skills; knowledge of insurance and hospital policies; and excellent computer and presentation skills.

Does this position have supervisory responsibilities?
No

Preferred Education/Experience
Knowledge and experience working with health insurances preferred.

Deadline to Apply
12/18/2023

University Community of Inclusion

The University of Kentucky is committed to a diverse and inclusive workforce by ensuring all our students, faculty, and staff work in an environment of openness and acceptance.

We strive to foster a community where people of all backgrounds, identities, and perspectives can feel secure and welcome.

We also value the well-being of each of our employees and are dedicated to creating a healthy place to work, learn and live.

In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors the University of Kentucky is a Tobacco & Drug Free campus.

As an Equal Opportunity Employer, we strongly encourage veterans, individuals with disabilities, women, and all minorities to consider our employment opportunities.

Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources.

These screenings may include a national background check and/or drug screen.

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