Transplant Finance Navigator

Memorial Hermann Health System; Houston (TX); On-site; USD 65,000 - 92,000; Full time

Job summary

Memorial Hermann Health System in Houston seeks a Transplant Financial Coordinator to support the transplant team and families with financial information. You manage insurance details, authorizations, and reimbursement strategies across the transplant cycle, including post-transplant care and long-term follow-up.

The role requires 3 years of relevant experience, strong MS Office skills, and knowledge of payer requirements, CPT/ICD-10.

Qualifications

• Three years of related experience in insurance, revenue cycle, or transplant.
• Proficient with Microsoft Office including Word, Excel, and PowerPoint.
• Knowledge of major health care insurance benefit structures and Medicare.
• Familiarity with hospital/provider billing and payer requirements.
• Familiarity with CPT, ICD-10, and HCPCS terminology.
• Ability to stay calm under pressure and handle urgent situations.
• Strong oral and written communication skills.
• Knowledge of provider networks.
• Independent decision-making capability.
• Ability to work with professionals and non-professionals in high-complexity situations.
• Strong interpersonal skills with patients and families regarding health and finances.
• Ability to assess changes in insurance coverage trends and impact.

Responsibilities

• Obtain and verify detailed patient and/or donor insurance benefit information for all aspects of transplant.
• Obtain insurance authorizations for transplant-related services and update clinical team.
• Participate in Medical Review Board meetings and care conferences as directed.
• Communicate clearance status and coverage status with the transplant team.
• Re-verify insurance coverage monthly/quarterly and update payer data.
• Collaborate with patients and families to address coverage gaps and funding options.
• Advise on spending down, COBRA, and government assistance eligibility for max reimbursement.
• Coordinate financial processes with Contract Management, Payer Relations, and Billing.

Skills

Interpersonal skills

Communication

Stress management

Healthcare customer service

Microsoft Office

Insurance/revenue cycle knowledge

Medical terminology

Independent decision making

Team collaboration

Education

High school diploma

College degree

TFC certification

Tools

Microsoft Office

Hospital systems

Job description

Memorial Hermann Health System in Houston seeks a Transplant Financial Coordinator to support the transplant team and families with financial information. You manage insurance details, authorizations, and reimbursement strategies across the transplant cycle, including post-transplant care and long-term follow-up.

The role requires 3 years of relevant experience, strong MS Office skills, and knowledge of payer requirements, CPT/ICD-10.