Financial Coordinator

Position Summary

The Transplant Financial Coordinator is responsible for collecting financial and insurance information from pre-transplant patients verifying insurance coverage obtaining required pre-certifications and serving as a financial resource throughout the transplant process. This role works closely with insurance case managers transplant patients the Transplant Social Worker and the transplant team to ensure appropriate financial planning coverage verification and authorization management.

The coordinator also reviews patient bills for inclusion in the Kidney Acquisition Cost Center (KACC) provides financial counseling manages provider contracts and supports patient-specific care standards while maintaining service excellence and patient satisfaction.

Essential Duties & Responsibilities

Insurance Verification & Benefits Coordination

• Obtain and review patient healthcare coverage information.
• Collect and verify insurance information from transplant patients.
• Verify transplant and living donor benefits with insurance carriers.
• Determine whether pre-certifications are required for evaluations transplant admissions follow-up care and related services.

Pre-Certification Management

• Obtain required pre-certifications from insurance companies.
• Communicate directly with insurance case managers regarding authorization requirements.
• Submit necessary patient information and supporting documentation for review.
• Notify case managers of transplant committee listing decisions when applicable.
• Maintain ongoing communication with insurance case management throughout the transplant process.
• Secure authorizations for post-transplant services and follow-up care.
• Provide business office staff and other providers with insurance and authorization information at the time of admission.

Financial Communication & Case Coordination

• Keep the transplant team informed of patient financial status and progression through the transplant process.
• Coordinate with physician offices and hospitals regarding living donor billing procedures.
• Notify managed care departments of patients who may require special contracting arrangements before evaluation or transplantation.
• Collaborate with the Transplant Social Worker and Department Director on complex financial cases.

Kidney Acquisition Cost Center (KACC) Management

• Review patient bills for eligibility and inclusion in the Kidney Acquisition Cost Center.
• Conduct initial bill reviews for KACC suitability.
• Enter applicable charges into the financial database.
• Prepare and distribute monthly reports to the Director and Accounting department.

Patient Financial Counseling

• Meet individually with pre-transplant patients to develop personalized financial plans.
• Educate and counsel patients regarding financial responsibilities associated with transplantation.
• Assist patients with planning for transplant-related expenses.
• Refer patients to the Transplant Social Worker for financial assistance programs and additional support resources when needed.

Contract Management

• Ensure provider contracts are established before appointments are scheduled and claims are processed.
• Conduct basic contract discussions with providers.
• Escalate complex negotiations to the Department Director.
• Maintain contract records and documentation within the contract management system.

Compliance & Service Excellence

• Demonstrate conduct consistent with organizational values and the Code of Conduct Ethics and Compliance Program.
• Adhere to Service Excellence standards in all patient provider and team interactions.
• Support patient-centered care initiatives and organizational quality standards.
• Perform additional duties and responsibilities as assigned.

Required Knowledge Skills & Abilities

• Knowledge of healthcare insurance verification and authorization processes.
• Understanding of HIPAA HITECH and healthcare compliance requirements.
• Strong interpersonal communication and customer service skills.
• Excellent organizational and time-management abilities.
• Ability to manage sensitive financial information with discretion and confidentiality.
• Proficiency in Microsoft Office Suite including:
  • Excel
  • Word
  • Outlook
• Experience utilizing insurance verification systems and databases.
• Ability to work collaboratively with multidisciplinary healthcare teams.

Education & Experience

Required

• High School Diploma or equivalent.
• Strong interpersonal and organizational skills.
• Intermediate computer proficiency including Microsoft Excel Word Outlook and insurance verification databases.

Preferred

• Experience in:
  • Patient Registration
  • Financial Counseling
  • Medical Insurance Verification
  • Healthcare Revenue Cycle Operations
  • Transplant Services or Specialty Healthcare Programs

Reporting Structure

Reports To:

• Transplant Manager
• Director of Transplant Services

Nesco Resource offers a comprehensive benefits package for our associates which includes a MEC (Minimum Essential Coverage) plan that encompasses Medical Vision Dental 401K and EAP (Employee Assistance Program) services.

Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.

Required Experience:

IC