Transplant Financial Review Coordinator 1

Transplant Financial Review Coordinator 1

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

• We serve faithfully by doing what's right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

The Transplant Financial Review Coordinator 1 verifies transplant coverage and medical benefits. Acquires necessary referrals and authorizations. Submits medical records to insurance companies for prior authorizations for transplant services and Immune Effector Cell Therapies. Monitors transplant patients to update insurance documentation, attending physicians, authorizations, and providers. Close communication is required with patients, insurance companies, and physicians.

Essential Functions of the Role:

• Obtains and submits medical records, provided by the Transplant clinical team, to the patient's insurance company, as requested.
• Follows up with insurance companies to ensure timely review of patient cases. Initiates requests for contracts, letters of agreement, and single case agreements when necessary.
• Participates in patient orientation classes to educate on the transplant financial review process. Topics include patient financial obligations, non-covered transplant services, financial policies, and alternative resources for patients who do not meet financial guidelines.
• Works within Electronic Medical Record to complete new transplant patient referrals, patient transplant listings, and reauthorizations in designated work queues.
• Calculates if the patient's transplant coverage meets the financial requirements policy. Accountable for obtaining transplant evaluation and listing authorizations for many patients. Once authorization is obtained or the patient does not meet financial requirements, communicates to the Transplant clinical team. This function repeats as insurance changes occur.
• Monitors transplant patients through all phases to update insurance data, attending physicians, authorizations, and other providers. Ensures all stakeholders are updated on patient status, financial status, and financial hold.
• Accountable for coordinating transplant deposits for private-pay patients.
• Rotates through on-call after business hours to complete urgent inpatient evaluation or listing requests.
• Participates in weekly Transplant Selection Committee meetings. Accountable for providing financial information if requested by Committee Chair.
• Assists with annual reverification in January of each year of transplant coverage for all patients pre-transplant through one year post-transplant.
• Answers department office number to assist with patient, provider, and insurance company questions related to transplant services.
• Completes monthly financial reports.

We believe that all people should feel welcomed, valued and supported.

Qualifications:

• EDUCATION - Associate's or 2 years of work experience above the minimum qualification
• EXPERIENCE - 2 Years of Experience

Baylor University Medical Center