Job Summary

Performs duties of moderate complexity, judgement, and scope in coordinating and managing all aspects related to insurance benefit information, authorization, billing and collections for all types of services. Will serve as a resource to patients and their families, clinical staff, physicians and insurance companies.

Essential Functions

• Coordinates and manages the billing and collection functions for all payor types.
• Notifies physician offices of contract periods, identifies and monitors accounts, determines correct reimbursement, bundles all bills for submittal to insurance companies, rebills claims as necessary, followings up on claim status, performs regular account maintenance, collects and distributes payments appropriately.
• Researches insurance benefits, options and potential patient financial needs and discusses findings with patients and their families.
• Develops a financial plan with patients and their families.
• Works with patients and develops resolutions to potential patient financial out-of-pocket exposure and helps them plan and overcome these obstacles.
• Obtains all necessary payer authorizations.
• Verifies and monitors coverage and other medical benefits and acquires necessary referrals and authorizations.
• Ensures that all payor approvals are current at all times.

Physical Requirements
Mobility required. Majority of the day spent sitting. Must be able to lift up to 5 lbs of patient charts. Work requires stretching to file or retrieve charts or manuals. Must be able to communicate with other groups and departments.

Education, Experience and Certifications

Bachelor’s Degree in Accounting, Finance or related field or 5 years of insurance related experience required. 1 to 2 years of reimbursement experience in a hospital setting is preferred. Must be able to work independently and possess strong organizational, time management and interpersonal skills and be able to prepare and analyze financial reports. Must be proficient with medical terminology and be familiar with clinical considerations as these relate to transplant cases. Extensive analytical skills and focus on details. Excellent written and oral communication skills required. Microsoft Excel, Word, STAR and IDX experience required. Databases, hospital registration, billing and clinical systems preferred.