Transplant Financial Coordinator-Hybrid

HYBRID: This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs. 

 

The Transplant Financial Coordinator is an advanced level position, responsible for resolving referral, precertification, prior authorization and/or financial clearance through the pre-transplant and post-transplant process. Courteously and professionally works with patients to outline financial obligations related to care, and provides options for patients to meet financial requirements, including assessing financial assistance eligibility, determining insurance coverage eligibility, establishing payment arrangements, collecting preservice payments and co-payments as needed. This position may be responsible for workload throughout all the Mayo Clinic sites, regardless of the representative’s physical location. In addition, this position may be responsible for pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access Prior Authorization department. This role requires interpretation of insurance coverage eligibility, insurance transplant contracts, and the submission of Letter of Agreement (LOA) and Individual Case Negotiation (ICN) requests to address any in/out of network coverage or self-pay issues. This position may participate in selection committee meetings with the Transplant Team from a financial aspect to assist the committee’s decision to accept/deny potential transplant recipients and the determination of the patient’s transplant listing status. This role may also include participation and collaboration with a multidisciplinary team in the development and implementation of protocol and standards of care planned for the transplant patient. This position will be responsible for monitoring and the updating of necessary documentation according to the United Network of Organ Sharing (UNOS) guidelines that may include listing, status changes and post-transplant follow up information. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations.

High School Diploma or GED and a minimum 5 years of experience in medical billing (hospital and/or professional), customer service and/or finance related field required. 

Associates Degree or higher preferred.

Certification Transplant Financial Coordinator (CTFC) preferred. Healthcare Financial Management Association (HFMA) Certification Preferred.

Advanced knowledge of ICD-10, CPT coding required. Advanced knowledge of third-party payor referrals and authorizations required. Excellent written and grammatical skills, including proper phone etiquette. Advanced computer/keyboarding skills. Must maintain regular and acceptable attendance.

Transplant financial counseling and billing experience preferred. Financial, analytical, and mathematical competencies preferred. Competence and experience with Epic preferred. Advanced knowledge of medical billing, reimbursement and collections processes preferred. Advanced knowledge of healthcare and transplant terminology preferred. Knowledge of insurance contracts and managed care experience preferred. Knowledge of solid organ transplants, bone marrow transplants (BMT), End Stage Renal Disease (ESRD), and Chimeric antigen receptor (CAR)-T cell therapy preferred. Knowledge of transplant billing requirements preferred. Knowledge of the Conditions of Participation (CoP), National Marrow Donor Program (NMDP), National Organ Procurement and Transplantation Network (OPTN), Scientific Registry of Transplant Recipients (SRTR), and all Federal Register's rules and regulations for organ acquisition preferred.  

**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.