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Job ID: 28730
Location: Chapel Hill, NC
Facility/Division: UNC Medical Center
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
The Transplant Financial Coordinator (TFC) is responsible for patient financial counseling and clarification of insurance issues to help facilitate access to and provide continuity of care for transplant patients. The Transplant Financial Coordinator achieves this by working with members of the transplant team, insurers and administrative personnel at the Transplant Center.
1. Financial Management of Post-Transplant Services - Facilitates resolution of patient billing and insurance issues. Provides financial counseling for patient when needed.
2. Participation on Interdisciplinary Transplant Team--Identifies and effectively communicates financial information to transplant team members with emphasis on patients who do not have adequate coverage. Communicates terms of transplant contracts to transplant team, social worker and pharmacy representative to ensure that patient is receiving care as defined by the contract. Contacts commercial insurance company to verify benefits and obtains prior authorization/pre-certification for the transplant admission. Contacts government insurance agencies to obtain specific guidelines verify benefits and obtain prior authorization for the transplant admission.
3. Patient Counseling and Financial Management of Pre-Transplant Services - Discusses benefits and other transplant financial issues with patient and/or family members with emphasis on the cost of transplantation. Advises patient on how to apply for Medicaid, Medicare and Social Security benefits and other financial programs as applicable. Maintains knowledge of transplant contracts to ensure that contract requirements are met. Identifies and effectively communicates any potential out-of-pocket liability to patients and/or their families. Verifies detailed patient insurance benefit information for all aspects of the transplant process, including but not limited to, outpatient prescription drugs, organ acquisition, living donor coverage, follow-up clinic visits and travel/lodging if necessary. Evaluates insurance status and determines whether COBRA insurance benefits or other financial resources will maximize reimbursement. Provides fund-raising information to patients regarding local and national fund-raising organizations
4. Policy Support - Refines, develops, implements and communicates departmental and health care system policies and procedures to employees, patients and their families. Serves as a resource for employees and management in the interpretation and application of a variety of policies and procedures. Monitors compliance with policies and procedures and makes recommendations for changes as appropriate.
5. Professional Development - Maintains membership with the National Transplant Financial Coordinators Association in order to receive updates on new transplant laws. Takes initiative to attend programs and seminars to maintain and upgrade professional skills and education and also staying abreast of new guidelines pertaining to Medicare, Medicaid and insurance plans.
6. Report Management - Utilizes codes to identify transplant patients in CMS tracking system and insure that correct insurance is on each account in SMS. Determines and assesses if patient?s medical services are transplant related or not and how benefits should be paid.
● Bachelor’s degree in an appropriate discipline (or equivalent combination of education, training and experience).
● No licensure or certification required.
Professional Experience Requirements:
● If a Bachelor's degree: Four (4) years of experience in health care operations, including two (2) years of experience with private and federal insurance programs.
● If an Associate's degree: Eight (8) years of experience in health care operations, including two (2) years of experience with private and federal insurance programs.
● If a High School diploma or GED: Twelve (12) years of experience in health care operations, including two (2) years of experience with private and federal insurance programs.
Knowledge/Skills/and Abilities Requirements:
Legal Employer: STATE
Entity: UNC Medical Center
Organization Unit: Heart Pre-Transplant
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity and affirmative action employer.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
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