Transplant Financial Counselor

 

Main characteristics

Location

Atlanta, Georgia

Company

Emory Healthcare

Job summary

Overview:
At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. Were empowered to influence change for, and with, our patients, their families, the community and each other.

As one of the leading academic medical systems, were eager to share what we learn with hospitals around the country, and the world. Weve got the backing, knowledge, experience and permission to lead the way in developing new and better approaches to preventing and treating disease, and our patients get treatments years before anyone else.

Were defining a new standard of care for humankind. Are YOU ready to join us?

Description:
JOB DESCRIPTION:

With minimal assistance, ensures optimal insurance coverage and payments for all pre, transplantation, and post transplant patient services.

Obtains detailed patient insurance benefit information including, but not limited to: outpatient prescription drugs, organ acquisition, follow-up clinic visits, and travel and housing if necessary.

Researches type of coverage, limitations and exclusions for appropriateness according to the transplant program financial criteria.

Works collaboratively with the insurance companies to obtain authorization for a transplant and to identify out-of-pocket expense for the patient.

Discusses benefits and other financial issues with patients and or family members during initial evaluation.

Serves as a resource for patients, family members, Social Workers, Coordinators, Physicians and Administrative staff on financial matters.

Serves as a resource to transplant candidates with respect to alternate funding and choices of insurance coverage, i.e., Medicare and Medicaid eligibility, COBRA, Social Security Disability, retirement plan, etc.

Retrieves any clinical data required by third party payers, and makes sure that such are available to payers in a timely manner if requested.

Serves as a resource to the transplant team, and provides explanation to clinical and administrative staff in regards to transplantation review and reimbursement criteria.

MINIMUM QUALIFICATIONS:

Associates Degree in Business with minimum of two (2) years experience in healthcare patient financial services or insurance setting OR five (5) years experience in healthcare patient financial services or insurance setting.

Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CPFC) preferred in hospital setting.

Knowledge of ICD-9 and CPT coding.

Third party payor experience required.

PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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Additional Details:
Salary: $18.27 - $30.69/hour

The grade and salary of the position are based on specific criteria met within the qualifications of relevant experience, skills, performance and internal equity.