Website Parkland Hospital
Dallas County's Public Hospital
Minimum 2 years medical insurance benefit coverage assessment, processing & invoices; including HMO and PPO experience
-The Transplant Financial Coordinator TFC is responsible for analyzing and validating the information needed to obtain financial approval for transplant
-The TFC will mitigate the financial risk by performing an accurate financial review along with a comprehensive analysis of patient payer specific benefits and patient liability
-Review benefit requirements and start the request for authorization approval for the transplant evaluation, admission, clinic visits, work-up and testing, organ procurement, and post-transplant services
-Review benefit requirements and start authorization, pre-certifications and /or pre-determinations for treatments
-Review benefits for appropriate coverage for services
-Review contracts and obtain clarification from contracting as needed
-Meet with patients and family members at the time of transplant evaluation; explain to the patients the anticipated costs of transplant services and patient responsibilities (i.e post-transplant meds); help patients and families create a financial plan when benefits are not sufficient to cover transplant costs
-Coordinate with Intermountain Contracting Services to create single case agreements for self-funded or international patients
-A Coordinate with Intermountain transplant clinical teams, social workers, etc, the patients financial situation, expected coverage and out of pocket expenses, additional funding sources as well as any potential concerns
-Additional duties as assigned by management
-Review and resolve any issues related to the patient as insurance coverage
-Help coordinate referrals to external transplant programs when the patient as insurance is out of network
-Follows transplant policies and procedures as they relate to obtaining the financial approval
-Coordinates these policies and procedures and works closely with the transplant billing team to ensure compliance
-Provide continuous financial counseling based on the patient as benefits and calculate the estimated post insurance expenses for the patient
-Interact with transplant clinical staff and patients to obtain patient demographics to begin the insurance verification process
-Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
-Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
-Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.
To apply for this job email your details to JACLYN.GEORGETTE@phhs.org