Transplant Financial Counselor
3 weeks ago
**Primary City/State**:
Phoenix, Arizona
**Department Name**:
Pre-Kidney Trans-Hosp
**Work Shift**:
Day
**Job Category**:
Revenue Cycle
Banner University Medical Center Transplant Institute is Arizona’s most experienced transplant center, providing comprehensive care to adult patients in pre and post-transplant acute clinics for heart, lung, liver, and kidney/pancreas transplant, as well as, long term follow up on the transplant recipient. As part of the Banner Health Academic Medical Division we offer Transplant Services in Phoenix and Tucson, AZ. Our Transplant Institute prides itself on delivering compassionate, quality care to our patients and families leading to successful, optimal outcomes.
As the Transplant Financial Counselor, you will have the opportunity to work in a fast paced, multidisciplinary team. In this role, you will be obtaining prior authorizations for each component of transplant from evaluation, the transplant surgery and the post-transplant care. You will also counsel the patient on their benefits and assess financial risk and resources available to assist.
This is a full time opportunity. Hours are Monday through Friday, 7AM to 9AM start time. There may be opportunity for a hybrid working schedule once training is complete.
Banner - University Medical Center Phoenix is a nationally recognized academic medical center. This world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, a number of unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus includes fully integrated multi-specialty and sub-specialty clinics, a new patient tower and two clinic buildings.
This position is a UNOS required role as part of the multidisciplinary team that covers all aspects of patient care throughout their evaluation, transplant and post-op care. This position is responsible for verifying patient insurance coverage specific to solid organ trasplant, determining eligibility for financial assistance programs, counseling patients and their family members and communicating with insurance companies and financial aid organizations to secure payment for transplant-related procedures. The position works closely with transplant physicians, social workers, and other healthcare professionals to ensure that patients receive the financial support they need to undergo life-saving transplant surgeries. Additionally, the position partners with hospital billing and reimbursement teams to ensure accurate billing and payment on transplant claims.
CORE FUNCTIONS
2. Performs pre-registration/registration processes. Ensures that all systems have accurate and complete information regarding insurance and billing for transplant vs non-transplant related services. Distinguishes the plan codes for the transplant coverage and the billing process related to each transplant contract. Reviews incoming referrals to the transplant programs to verify that their insurance coverage will adequately cover their care including organ acquisition fees, provider fees, and post-transplant medications. Verifies in/out-of-network coverage and center of excellence requirements with the payer. Obtains minimum requirements of payer to request authorizations for all phases of transplant care.
6. Reports admission for transplant surgery to insurance case managers and documents authorization in all applicable billing systems. Additionally, reports discharge from the hospital after organ transplant to secure post-transplant care authorization. Documents in multiple EMR and billing systems to ensure that the information is available to all involved team members.
7. May provide leadership and training to other members of the financial team and serves as a resource for internal and external customers.
8. Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence.
9. Works independently under general supervision, leads and follows structured work routines. Works in a fast paced, multi-task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position is an integral part of the care team, as they serve as the primary contact for all financial aspects of the patient’s care, both for internal and external customers. Internal customers include all levels of the clinical care team, as well as other administrative support positions throug
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