Transplant Finance & Benefits Specialist

WVU Medicine; Morgantown (WV); On-site; USD 70,000 - 100,000; Full time

Job summary

WVUH West Virginia University Hospitals is seeking a Transplant Financial Coordinator to manage insurance verification, precertification, prior authorization, and financial clearance throughout the transplant journey.

You will collaborate with a multidisciplinary team to uphold protocols of care and ensure accurate transplant billing while assisting patients with financial obligations and payment arrangements.

Qualifications

• Five years of healthcare finance experience or a bachelor’s degree with three years of healthcare finance experience.
• HFMA CRCR certification and TFCA membership are preferred (to be completed as established by department)
• Knowledge of revenue cycle, payers, and EHR requirements.

Responsibilities

• Verify detailed patient insurance benefit information across transplant processes.
• Evaluate insurance status and COBRA or other financial resources to maximize reimbursement.
• Communicate potential out-of-pocket liability to patients and families.
• Obtain prior authorization from commercial and government insurance for transplant services.
• Provide information on local and national fundraising resources to patients.
• Maintain membership with the National Transplant Financial Coordinators Association.
• Assess transplant-related services for coverage and payment.
• Review self-pay donor statements for Medicare compliance.
• Attend weekly transplant department meetings.
• Demonstrate mature problem-solving and conflict management with patients and teams.

Skills

Excellent written and communication

Interpersonal communication

Analytical and problem solving

Multitasking in fast-paced environment

Independent project work

Excel and Access proficiency

Knowledge of payer regulations

Education

Bachelor's degree in business/health information/related

High school diploma or equivalent

Tools

Microsoft Excel

Microsoft Access

Job description

WVUH West Virginia University Hospitals is seeking a Transplant Financial Coordinator to manage insurance verification, precertification, prior authorization, and financial clearance throughout the transplant journey.

You will collaborate with a multidisciplinary team to uphold protocols of care and ensure accurate transplant billing while assisting patients with financial obligations and payment arrangements.