POSITION SUMMARY/RESPONSIBILITIES:

Coordinates the progression of charge capture, billing, and collection functions of Transplant patients in accordance with federal and state billing and compliance guidelines as well as internal policies. Performs comprehensive investigation and verification of health insurance for transplant care, inclusive of multidisciplinary services. Verifies insurance authorizations, ensures appropriate charge capture, monitors collections, and verifies accurate payment. Responsible for the complete episode of care for all potential candidates and living donor candidates, including pre-transplant financial clearance and assessment, post-transplant follow-up, coordination of services, and maintenance services for the extent of the services provided to the patient. Interfaces with external financial entities and insurers to verify authorization for all services related to transplants. Monitors reimbursement and cash collections to ensure contracted rates are remitted.

EDUCATION/EXPERIENCE

A high school degree or its equivalent is required. Bachelor’s degree preferred. Three years increasing responsibility in administrative analysis is required. Experience in insurance and medical terminology, billing, and collections issues is preferred. Knowledge of ICD-10 and CPT coding is preferred. Related experience in healthcare or health insurance environment with a progressive understanding and user-end expertise in both patient and physician billing and registration systems is preferred.