Financial Coordinator, Lung Transplant Program Full Time Days

Company Description

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Job Description

The Financial Coordinator: The Transplant Finance Coordinator reflects the mission, vision, and values of Northwestern Memorial, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

This position ensures continuity of admitting, registration, authorizations, billing, and other services across transplant disciplines, understands payer contracts in regard to authorizations and reimbursement models, understands and supports United Network for Organ Sharing (UNOS) principals. Coordinator is a first line of escalation and support for Transplant Liaisons and transplant clinics. Coordinator can provide cross-discipline coverage in case of emergency transplant and other escalations. This position supports Transplant Manager in escalations and projects.

Responsibilities:

• Serve as a subject matter expert in efforts to improve transplant patient access, financial clearance, and prior authorization operational workflows between the various internal and external teams, including transplant clinical programs, contracted and non-contracted payers, Case Management, Managed Care, and Financial Counseling.
• Perform authorization, pre-certification, and all other financial liaison tasks to ensure timely transplant evaluation and transplant authorization approvals. These tasks will ensure patients are financially cleared to proceed with transplant services and would eliminate financial risks (denials and non-payments).
• Maintain best patient communication and education practices with patients, collaborate with clinics to uphold highest standards in patient communication on all financial matters.
• Act as the first level escalation for operational issues, patient concerns, provide knowledge- based information to patients and clinics. Provide timely responses to patients to maintain and improve patient satisfaction.
• Stay current with payer policies and guidelines with Medicare, Medicaid, UNOS and/or ASTCT and communicate updates to the team via group meetings. Attend training and seminars.
• Collaborate and work with transplant clinics on new programs to ensure Financial Clearance processes accommodate the new therapies.
• Collaborate and assist Manager with optimization projects which include development and maintenance of department policies and procedures.
• Conduct periodic reviews of processes and workflows, which include quality audit reviews and provide feedback to team and manager of findings, proposing solutions.
• Demonstrate exemplary work quality and assist in the development of goals and objectives for Transplant Financial Coordinators.
• Adhere to all regulatory requirements, reporting any suspected breaches or concerns to the Manager and Corporate Integrity and Compliance (HIPAA, Patient Privacy, ACA Consumer Protections).

AA/EOE

#NMH1

#LI-AD1

Qualifications

Required:

• Required Minimum of five (5) years of work experience in patient access, medical billing office, patient customer service, and/or insurance company.
• Bachelor's degree or equivalent work experience
• Excellent internal/external customer service skills when dealing with patients, authorized guarantors, payers and other external contacts, co-workers, and internal clients.
• Strong knowledge of medical terminology, insurance plan authorization and treatment approval practices and requirements.
• Excellent communication skills to include oral and written comprehension and expression.
• Detail-oriented, strong organizational skills, and ability to be self-directed.
• Flexibility to perform other tasks as needed in a work environment with changing work needs.
• Exhibit behaviors consistent with principles of excellent service, standards of performance improvement and NMHC values.
• Experience and knowledge of PC applications, including Microsoft Office applications.

Preferred:

• Experience in Epic Transplant, Access, and Billing modules.
• Knowledgeable  of Process Improvement methodologie