About this role
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
Work Shift Day (United States of America)
Job Summary:
Coordinates patient financial services for the transplant program. Responsible for verifying insurance coverage of recipients and donors for transplant evaluation, the transplant event, and financial needs after transplant. Responsible for educating patients regarding insurance benefits and other financial issues related to transplantation. Works with patients to address insurance coverage gaps via alternative funding options. Works with government and private insurance companies for transplant patients.
Core Responsibilities and Essential Functions:
Insurance and Benefit Assessment: Assures the financial viability of all transplant referrals throughout the continuum of transplantation. Verifies insurance coverage and benefits for all transplant-related services (hospital, physician, pharmacy and ancillary). Coordinates and initiates pre-certification/pre-authorization with necessary parties. Educates patients regarding transplant insurance coverage including but not limited to inpatient, outpatient, prescription, travel, and lodging. Patient Support: Serves as a resource for patients and their family members on all financial matters. Works to find alternative funding options when necessary. Refers patients to appropriate funding resources outside of the hospital if applicable. Collaborates with local and national resources for patient financial assistance or fundraising needs. Documentation: Adheres to documentation policies and procedures. Documentation is consistent with all applicable federal and state regulations and any amendments pertaining to Medicare, Medicaid or health insurance coverage. Consistently completes documentation in a timely manner. Knowledgeable of HIPAA regulations and follows all security policies. Updates data in OTTR in a timely manner. Education and Development: Demonstrates accountability for professional growth and development. Demonstrates up-to-date knowledge of applicable federal and state regulations related to patient insurance, benefits, and coverages. Completes hospital assigned education and competencies in a timely manner. Participates in educational in-services offered by the program, cancer center and hospital, as applicable. Possesses knowledge of transplant-related coverage by government and private payers. Communication: Demonstrates appropriate and professional use of written and verbal communication skills. Provides pertinent patient information to the multidisciplinary team in a clear and timely manner. Obtains financial clearance and updates insurance status changes as needed. Assures appropriate utilization of OTTR and EMR to resolve financial issues and complete daily assignments. Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
• High School Diploma or GED Required.
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
Required Minimum Experience:
Minimum 2 years Physician office/hospital scheduling/financial services to include insurance verification Required and
Required Minimum Skills:
Computer literacy, excellent organization, and communication High Knowledge of health insurance benefits managed care or reimbursement. Transplant financial experience Low
Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.