Transplant Finance Navigator

Lehigh Valley Health Network; United States; On-site; USD 60,000 - 90,000; Full time

Job summary

Lehigh Valley Health Network is seeking a Transplant Financial Coordinator to manage the financial aspects of patient care from evaluation through and after transplantation, working with patients and families compassionately to facilitate access and continuity of care.

The FC will collaborate with the transplant team, insurers, and administrative personnel to secure authorizations, address coverage gaps, and ensure maximum financial support for patients while maintaining confidentiality and

Qualifications

• High School Diploma or GED required.
• 2 years experience working in transplant or related field.
• Ability to anticipate and understand customer financial needs; document and/or relay patients needs to appropriate personnel.
• Demonstrates expert knowledge in determining third-party insurance medical benefits and billing requirements.
• Must be able to maintain confidentiality and have an understanding of patient’s rights.
• Must understand oncology‑specific treatments and related insurance coverage issues, including rules governing medical necessity.
• Must possess the ability to combine compassion with strong professional skills.

Responsibilities

• Performs financial screening of all patients for transplantation including, but not limited to: outpatient prescription drug coverage (including immunosuppressive medications); follow-up visits; housing/travel if necessary. Identify and effectively communicate financial information to patients and their families with emphasis on identifying potential out of pocket costs.
• Discuss benefits and other transplant financial concerns with patients during transplant evaluation.
• Advise patients on insurance and billing issues and options. Serve as resource for patients/family members. Work with patients, family, team members to help address insurance coverage gaps and assist with finding alternative funding sources.
• Obtain all necessary payor authorizations and pre-certifications, verify transplant coverage and other medical benefits. Acquire necessary referrals and authorizations. Acts as a contact for insurance case managers primarily, but limited to, obtaining pre-certification and authorizations. Collects and submits necessary documentation and correspondence. Performs and communicates related follow-up.
• Keeps up to date on job related regulations to ensure maximum financial coverage for patients and appropriate reimbursements. Adheres to regulations in accordance with job specific governing bodies. Completes time studies monthly.
• Monitor and update information regarding insurance data, physicians, authorizations, and preferred providers. Assist patients with questions concerning insurance and other financial issues.

Skills

Customer financial needs

Insurance benefits & billing

Oncology coverage knowledge

Compassion with professionalism

Education

High School Diploma/GED

Associate’s Degree

Job description

Lehigh Valley Health Network is seeking a Transplant Financial Coordinator to manage the financial aspects of patient care from evaluation through and after transplantation, working with patients and families compassionately to facilitate access and continuity of care.

The FC will collaborate with the transplant team, insurers, and administrative personnel to secure authorizations, address coverage gaps, and ensure maximum financial support for patients while maintaining confidentiality and