Finance Specialist, Transplant, Full-Time, Days, 8:00am-4:30pm

Transplant Finance Specialist

Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial - located in the heart of the City of Miami - has been ground zero for some of the world's greatest medical breakthroughs and important moments in South Florida. We've grown into one of the nation's largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world's most skilled and highly regarded multidisciplinary team of healthcare professionals.

Transplant Finance Specialist is responsible for coordinating and clarifying the available financial resources for transplant patient care.

Responsibilities:

• Complete the Medicare Time Study Cost Report on alternating weeks on a monthly basis.
• Medicare requires that all Miami Transplant employees whether directly or indirectly involved in patient care complete this spreadsheet monthly.
• This spreadsheet requires a breakdown of the entire week of work allocated for all pre/post-transplant patients.
• Attends Committees/Support Groups as necessary, including but not limited to weekly Listing Committees specific to each organ, MELD score review meeting, Quality Committee meetings, and patients/families support groups.
• Be proficient in navigating OTTR. OTTR is an application specifically used in the Miami Transplant Institute that collects and stores all demographic, financial, organ type, status, date of Transplant, Re-Transplant, Providers, and all other pertinent information pertaining to all patients in a refereed, evaluated and listing status.
• Performs various patient interviewing and fact-finding tasks upon registration, pre-admission, and collects or verifies insurance and/or third-party information in order to assure funding and settlement of patient accounts.
• Performs financial screening and pre-registration, functions as a point of contact. Determines the patient's financial responsibility and credit level and initiates collection process following Patient Access department protocol.
• Refers patients to the Department of Patient Financial Services for financial assessment and determination of eligibility, as needed.
• Prepares and ensures proper documentation of the patient's account package including designated hospital forms and copies of required documents. Ensure that the registration documents are scanned.
• Facilitates pre-certification and authorizations for designated payors prior to appointment. Accurately collects all pertinent demographic and funding information at point of contact.
• Completes cross-training to assist in other potential service departments.
• Stays abreast of new health care trends and maintains knowledge of various payors and third-party funding. Maintains patient appointment logs and/or productivity reports, as assigned.
• Maintains a working knowledge of basic medical terminology and inter-departmental functions. Maintains appropriate inter-departmental communications to enhance patient services.
• Inputs and retrieves data on a personal computer as needed.
• Responds promptly to patient inquiries and to telephone calls by the third ring.
• Communicates in a friendly, courteous and caring manner and promotes the patient first philosophy at all times.
• Ensure the proper financial classification of patient accounts in accordance with established guidelines and make financial classification changes when warranted.
• Researches any outstanding account balances for the patient and initiates collective efforts as necessary.
• Verifies eligibility and authorizations from all third-party funding sources and obtains patient benefits.
• Develops third party funding and/or evaluates patients for referral to public medical assistance programs.
• Monitors and works the accounts receivable according to Patient Financial Services guidelines and contractual agreements.
• Assists with the coordination of audits and refunds to patients and other third-party payors.
• Interacts with hospital affiliated agencies and all County, State and Federal Agencies. Maintains knowledge of various payors and third-party funding areas.
• Keeps the supervisor informed on any unusual problems which may hinder the timely collection of an account.
• Obtains required patient/guarantors' signatures where applicable.
• Answers all telephone inquiries regarding patient accounts.
• Properly handles and processes correspondence and incoming mail.
• Initiates patient contact either in person, by phone or correspondence, accordingly. In order to secure the necessary information to achieve funding for account balances.
• Interprets contract items and applies such in the resolution of outstanding claims.
• Reconciles daily account flow for future admission/procedure.
• Follow-up accounts in the Patient Benefits System.
• Coordinates the financial clearance for potential transfers to JMH.
• Responds to billing inquiries, as necessary.
• Performs charge entry, patient check in and check out as applicable.
• Obtain and verify detailed patient insurance benefit coverage for all phases of the transplant process; and assist in acquiring the necessary referrals and authorizations.
• Review benefit and other transplant financial issues with patients or family members during the initial evaluation; including, advising patients insurance and billing issues and available options.
• Serve as a patient financial liaison for patients and their families; includes assisting patients with questions concerning insurance and financial issues.
• Monitor and update patient financial and demographic information regarding insurance, physicians, authorizations, and preferred providers.
• Effectively communicating financial information to transplant team members, patients, and their families with an emphasis on identifying potential out of pocket expenses and addressing insurance coverage gaps.
• This includes assistance with identifying alternative funding options.
• Facilitating resolution of patient billing issues.
• Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
• Performs other related duties as assigned.

Generally requires 3 to 5 years of related experience.

High School diploma is required.

Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications.

Valid license or certification is required as needed, based on the job or specialty.

Jackson Health System is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law.