Transplant Financial Associate

• Researches and verifies insurance coverage and limitations for all patients referred for transplant evaluation and transplantation, including determination of available insurance coverage for unrelated bone marrow donor search.
• Submit and secure required insurance precertification authorizations for transplant episode (evaluation, waitlist, transplant and post-care). Complete monthly insurance verification on all UNOS listed patients.
• Writes or obtains from physician a “letter of medical necessity” and associated documents, send to provider and follow-up on response by providing necessary documentation of coverage and communication of status to the clinical coordinator responsible for care.
• Provides financial counseling on choices of insurance coverage, including COBRA, Social Security Disability, Illinois Medicaid, and new employee coverage to all potential transplant candidates and all established transplant patients.
• Develops and coordinates financial profile for all patients with inadequate or no insurance. This profile will include the patient’s responsibilities including any deposits or actions required by the candidate, such as pre-authorization or pre-certifications. The transplant financial coordinator with present the financial profile at evaluation meetings and other pertinent meetings with hospital administration.
• Determines insurance coverage for immunosuppressive medications and other transplant related discharge medications and arrange pharmacy charge account for each patient with insurance coverage for medications.
• Schedule / coordinate multidisciplinary transplant evaluations. Gather external patient records, enter external labs results in EPIC.
• Generates appropriate statistical reports at the request of the transplant administrator (such as fiscal year/calendar year volumes and the transplant dashboard) on the transplant program when needed and maintains a list of transplant candidates, their financial status, transplant stage and pre-certification status.
• Maintains an awareness of the transplant contracts held by the hospital and their terms/conditions and implications. Completes Medicare enrollment forms for Kidney Transplant recipients.
• Demonstrates behavior consistent with providing an open, professional and congenial work environment. The transplant financial coordinator supports the goals of the transplant center and hospital, acts with initiative to problem solve and assumes responsibility for personal performance.
• Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.

• High School diploma or GED equivalent required. Bachelor’s degree preferred.
• Minimum of 2 years of experience in transplant coordination, utilization review, financial counseling or insurance reimbursement strongly preferred.
• Must possess knowledge of insurance regulations, health care issues, medical terminology and have excellent organizational and interpersonal communication.
• Must be able to interact effectively with various levels of hospital staff, management and physicians.
• Exhibit tactful, compassionate and responsible interpersonal skills toward patients, their families and providers throughout the financial screening and evaluation process.

Ann & Robert Lurie Children's Hospital of Chicago