Transplant Financial Coordinator - UWMC-Montlake Transplant Services

University of Washington Medical Center
- Montlake Transplant Services has an outstanding opportunity for a Transplant Financial Coordinator.

Transplant Services at UW Medical Center
- Montlake combines the clinical, academic and research activities of the transplantation and cardiothoracic surgery divisions at UW Medicine. Our board-certified surgeons perform most of the multi-organ procurements in Washington, Alaska, Montana and northern Idaho. We’re organized around the following multidisciplinary clinical teams, all of which provide transplant care with compassion, integrity and respect for individual dignity: heart transplantation, kidney-pancreas transplantation, liver transplantation, and lung transplantation.

Through Seattle Children’s, we offer pediatric kidney, liver and heart transplantation services. at UW Medical Center
- Montlake also offers programs in autologous bone marrow transplants and high-dose chemotherapy.

Full-time, 40 hours/weekly, M - F, Hybrid Days (3 days in office, 2 day from home)

Office located at UW Medical Center
- Montlake

Conveniently located near public transportation Make a difference for the patients and employees we serve Opportunity to provide career growth PRIMARY JOB RESPONSIBILITIES Obtain and document detailed patient insurance benefit information for all phases of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and lodging, if necessary Obtain all necessary authorizations from payers, verifying transplant coverage and other medical benefits and obtaining referrals and authorizations if required.

Request a Benefit Level Exception (BLE) or a Single Case Agreement (SCA) as appropriate from the UW Medicine Contracting Department for non-contracted health plans Obtain all necessary information, including clinical documentation, required by payors for approval of different transplantation phases, including benefit verification, payor authorization, referrals, precertification, and case management Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems;

initiate communication with appropriate agencies and clinical staff for appeal of denials;
Conduct required follow-up on all initiated prior authorizations in an effort to obtain the final authorization Meet with transplant candidate, potential living donors and/or family to explain insurance coverage, treatment costs, and hospital billing policies Ensure that adequate insurance benefits or funding arrangements are in place prior to transplant. Consistently document all interactions with patients and family members Provide quality service to patients by providing comprehensive and ongoing financial counseling.

Serves as a resource to transplant candidates and their families and living donors regarding transplant payor benefits, billing issues, alternative funding options, and personal financial responsibilities regarding the transplant.

• Obtain and document detailed patient insurance benefit information for all phases of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and lodging, if necessary
• Obtain all necessary authorizations from payers, verifying transplant coverage and other medical benefits and obtaining referrals and authorizations if required.
• Request a Benefit Level Exception (BLE) or a Single Case Agreement (SCA) as appropriate from the UW Medicine Contracting Department for non-contracted health plans
• Obtain all necessary information, including clinical documentation, required by payors for approval of different transplantation phases, including benefit verification, payor authorization, referrals, precertification, and case management
• Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems
• Initiate communication with appropriate agencies…