Job Openings

Transplant Financial & Charge Coordinator

Job ID: BH391165

Category: Customer Support, Customer Service

Specialty: Other

Transplant Financial & Charge Coordinator
Location: Boston, MA 02118
*preference for onsite local candidates or hybrid, but open to qualified remote candidates nationwide
Hours: 40 hours a week

POSITION SUMMARY: 

The Transplant Financial and Charge Coordinator serves as the primary point person and resource for all  pre and post-financial planning for BMC’s kidney transplant patients, and is responsible for obtaining  detailed patient insurance benefit and financial information for all aspects of the transplant process,  including but not limited to pre-transplant outpatient visits/testing, inpatient transplant surgery,  prescription drug coverage and post-transplant outpatient visits. Additionally, the Transplant Financial  and Charge Coordinator is responsible for ensuring appropriate authorizations are obtained and  documentation is prepared to allow for appropriate billing for all charges. The candidate will also be  responsible for reviewing all outpatient charges on all transplant accounts to ensure they are processed  correctly. This individual will serve as a key member of the transplant multidisciplinary team, and will  interact with patients, members of the transplant multidisciplinary team and members of BMC on a  daily basis. 

EXPERIENCE: 

  • Three to five years of finance or insurance and/or benefits experience. Experience as a transplant  financial coordinator preferred. 
  • A strong understanding and knowledge of a wide variety of health insurance and benefits is a  must, as well as exceptional research skills and an ability to uncover information independently. 
  • Must be highly proficient in Microsoft Office products, to include: PowerPoint/Excel/Word/Outlook. 
    Previous experience in EPIC preferred but not required.

ESSENTIAL RESPONSIBILITIES / DUTIES: 

  • Registers all new patients referred for kidney transplant services, ensuring the patient has the  appropriate referrals, insurance coverage and authorizations for pre-listing evaluation. Meets  with each new evaluation in transplant clinic to discuss detailed financial screening. Maintains  records of financial clearance of each patient and reports on status as needed. 

  • Verifies authorizations, confirms primary and secondary payers, and identifies which  contract/plan will provide payment for all planned phases of care. 

  • Assesses adequacy of coverage for each patient’s anticipated treatment course. Intervenes by  counseling the patient when coverage is not adequate, assist eligible patients with referrals to  federal, state and third party payers. Screens for discounts, restricted funds or charity care if  appropriate. 

  • Requests authorizations for planned services and submits clinical justification as required under  the direction for transplant clinical team. Obtains reauthorizations as necessary. Updates the 

  • clinical administrator and operations manager weekly regarding all financial issues and  authorization statuses. 

  • Manages 175+ active recipient wait list, and runs insurance checks at least once per month to  confirm all patients’ eligibility. 

  • Oversees collection of Medicare Cost Report time study data one week per month from all staff  and providers involved with pre- and post-transplant services. 

  • Works with BMC finance department to ensure all Medicare Cost Report data is accurately  interpreted. 

  • Monitors financial situation of all kidney recipients, post-transplant, for up to 24 months, and  coordinates insurance and/or benefits adjustments. 

  • Oversees all transplant-related charge workqueues and reviews and processes all transplant related charges. Communicates with billing providers to ensure proper coding. 

  • Remains up-to-date on all UNOS, state and federal regulations concerning kidney transplant  reimbursement and payment processes. 

  • Works to ensure donor payment structure is set up accordingly and consistently monitors  insurance information for changes. 

  • Meets routinely with department leaders to report status and progress of financial planning  process for donor and recipients, and raises and addresses any outstanding issues. 

  • Captures and shares best practices across engagements. 

  • Fosters an environment of teamwork and camaraderie. 

  • Maximizes BMC’s training resources to better the transplant program and reinforces  department’s image in the engagement environment. 

Administrative Functions 

  • Shares the responsibility for ensuring the department operates in an effective, efficient and  professional manner. 

  • Completes all reports, spreadsheets, and/or other correspondence as necessary. 

  • Establishes and maintains administrative office filing system for documents related to job  function. 

  • Schedules and coordinates logistics of relevant routine meetings with Chief of Transplant  Surgery and Practice Manager. 

  • Performs other duties as assigned or as necessary. 

  • Must adhere to all of BMC’s RESPECT behavioral standards.

  • (The above statements in this job description are intended to depict the general nature and level of  work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list  of accountable duties and responsibilities required). 

EDUCATION: 

Two year college degree (Associates) in business, health, accounting, finance or related studies required.  Bachelor’s degree preferred. 

The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Type: Temp/Contract

Location: Remote Based