Clinical Financial Spec.

BJC HealthCare; St. Louis (MO); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k) with match

Tuition assistance

Paid time off

Disability insurance

Flexible spending accounts

Job summary

St. Louis Children's Hospital, part of BJC HealthCare, is seeking a Clinical Financial Specialist for its bone marrow transplant team. The role emphasizes financial and clinical collaboration to optimize transplant-related reimbursement.

Ideal candidates bring prior authorization experience or clinical knowledge, and the position requires eligibility to work in Missouri or Illinois with hybrid arrangements.

Qualifications

• Experience with prior authorization or clinical knowledge is preferred.
• Background in medical billing/finance or payer communications helpful.
• Strong communication to educate teams about insurance coverage and transplantation criteria.

Responsibilities

• Assist development of global managed care and single-patient discount contracts.
• Complete financial assessments at transplant referrals.
• Generate statistical reports for clinical and financial programs.
• Educate clinicians and non-clinical staff on insurance coverage, contracting, and transplant criteria.

Skills

Prior authorization

Clinical knowledge

Education

Bachelor's degree (Business/Nursing)

Job description

Additional Information About the Role

St. Louis Children's Hospital is seeking a Clinical Financial Specialist for our bone marrow transplant team!

Ideal applicants will have a background in prior authorization and/or some clinical knowledge.

This is a HYBRID role, and applicants must be located in Mo. or Il.

Overview

St. Louis Children’s Hospital is dedicated to improving the health and lives of children. As one of the top-ranked children’s hospitals in the country, St. Louis Children’s provides care in more than 50 specialty areas through a dedicated team of physicians, nurses, staff and volunteers. Along with inpatient and outpatient medical care, the hospital offers education, wellness and injury-prevention programs to fulfill its mission to “do what’s right for kids.”

Providing comprehensive, high-quality care and serving as an advocate for children has been St. Louis Children’s commitment since its inception in 1879. Today, the hospital serves patients and families across a 300-mile service area, and has seen patients from all 50 states and more than 80 countries.

St. Louis Children’s consistently ranks among America’s Best Children’s Hospitals by U.S.News & World Report in all surveyed categories. In 2021, St. Louis Children’s was one of eight children’s hospitals to rank in the top 25 of all 10 specialties. The hospital’s academic and physician partner, Washington University School of Medicine, is one of the top-ranked medical schools in the United States. Since 2005, St. Louis Children’s has been designated as a Magnet® hospital for nursing excellence from the American Nurses Credentialing Center® (ANCC).

Preferred Qualifications

Role Purpose

Assists financial and clinical administrators, physicians and surgeons, and other medical school management staff to achieve favorable reimbursement for clinical and professional services provided across specific patient population's continuum of care.

Responsibilities

• Assists in the development of global managed care and single patient discount contracts.
• Completes the financial assessment at the time of a transplant patient referral.
• Generates statistical reports pertaining to the clinical and financial programs.
• Educates various audiences (both clinical and non-clinical) regarding insurance coverage, contracting, criteria for transplant listing and transplant program protocols.

Minimum Requirements

Education

• Bachelor's Degree
• Business/Nursing related

Experience

• 2-5 years

Supervisor Experience

• No Experience

Benefits and Legal Statement

BJC Total Rewards

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary.

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer