Department/Unit:
Renal Transplant Service
Work Shift:
Day (United States of America)
Salary Range:
$46,947.00 - $65,726.00
The Transplant Financial Coordinator serves as the primary financial liaison for patients undergoing transplantation. This role ensures that patients and their families understand the financial aspects of the transplant process, including insurance coverage, authorizations, out-of-pockets costs, and available resources. The coordinator works closely with patients, clinical teams, all insurers to include Medicare and Medicaid, collaborates with social work for additional insurance acquisition, minimize financial barriers, and support compliance with payer requirements.
Essential Duties and Responsibilities
- Obtaining detailed patient insurance benefit information for all aspects of the transplant process, including but not limited to, outpatient, outpatient prescription drugs, organ acquisition, follow-up clinic visits, and travel and housing if necessary.
- Discussing benefits and other transplant financial issues with patients and/or family members during initiation evaluation.
- Advising patients on insurance and billing issues and options. Serving as a resource for patients and their family members on financial matters to include navigating Medicare, Medicaid, commercial plans, and secondary coverage.
- Obtaining all necessary payor authorizations. Verifying transplant coverage and other medical benefits and acquiring necessary referrals and authorization.
- Monitoring and updating information regarding insurance data, physicians, authorizations, and preferred providers. Assisting patients with questions concerning insurance and other financial issues.
- Identifying and effectively communicating financial information to transplant team members, patients and their families with emphasis on identifying any potential patient out of pocket liability.
- Partner with transplant team members (physicians, nurses, social workers, pharmacists, case managers) to integrate financial planning into patient care.
- Working with patients, their families and team members, when possible, to help address insurance coverage gaps via alternative funding options.
- Facilitating resolution of patient billing issues.
- Stay updated on changes in insurance policies, Medicare/Medicaid regulations, and hospital policies related to transplantation.
- Provide financial clearance before key transplant milestones (evaluation, listing, surgery, follow-up).
- Initiates encounter, coordinates seminar and initial evaluation appointments.
Qualifications
- High School Diploma/G.E.D. - required
- Associate's Degree in Business, Finance, or Healthcare - preferred
- 1-3 years Background in Finance, healthcare administration, or a related field - required
- 1-3 years Years in healthcare billing, insurance coordination, or financial counseling (transplant - preferred). - required
- Knowledge of Medicare, Medicaid, and commercial payer policies. - required
- Ability to manage financial and medication information with discretion and empathy.
- In-depth understanding of payer guidelines and healthcare reimbursement.
- Ability to work collaboratively in a fast-paced, multidisciplinary environment.
- Strong problem-solving and conflict-resolution skills, patient advocacy skills, and knowledge of Medical Terminology.
- Ability to work with others to accomplish a task or goal, flexibility in work practices, able to work effectively with others to find solutions.
- Able to deal pleasantly and effectively with a wide range of people of different ages and cultures, in potentially volatile and emotionally charged situations.
Equivalent combination of relevant education and experience may be substituted as appropriate.
Physical Demands
- Standing - Occasionally
- Walking - Occasionally
- Sitting - Frequently
- Talking - Constantly
- Hearing - Constantly
Thank you for your interest in Albany Med Health System!
Albany Med Health System is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.