Transplant Financial Coordinator

C002 Medical University Hospital Authority (MUHA); United States; On-site; USD 65,000 - 90,000; Full time

Job summary

The Transplant Financial Coordinator at Medical University of South Carolina (MUSC) manages financial aspects of transplant care for both adult and pediatric patients. You will analyze benefits, coordinate authorizations, and liaise with payors to ensure accurate billing and reimbursement across transplant services.

Working within a multidisciplinary team, you will serve as a subject‑matter expert on complex contracts and regulatory requirements, guiding patients and families through

Qualifications

• Bachelor degree and two years of healthcare experience, or high school diploma and 5 years of job experience in referral management, oncology navigation or patient access.
• Knowledge of complex medical terminology.
• Strong interpersonal skills and ability to build relationships internally and externally.
• Strong organizational skills and ability to prioritize/reprioritize.

Responsibilities

• Perform financial clearance review and analysis for transplant candidates, donors and families.
• Analyze patient and payor benefits and patient liability; coordinate with payors and MUSC billing teams.
• Communicate authorization, coverage and billing requirements to patients and providers.
• Ensure accurate billing, reimbursement and contract adherence across transplant services.

Skills

Interpersonal skills

Organizational skills

Verbal and written communication

Autonomy

Teamwork

Multi-tasking

Critical thinking

Education

Bachelor's degree

High school diploma

Job description

Job Description Summary

Job Description Summary The Transplant Financial Coordinator, under minimal supervision, is responsible for the analysis, validation, regulatory and compliance activities associated with coordinating financial aspects of care for adult and pediatric transplant candidates, donors, and their families. The TFC mitigates the financial risk to MUSC by performing an accurate financial clearance review along with a comprehensive analysis of patient and payor specific benefits and patient liability. Performs a variety of complex business functions, collates financial and clinical documentation, conducts research, analyzes and organizes data, implements and coordinates financial aspects of care, conducts financial screening assessments, and functions as a liaison between transplant candidates, the transplant center, and insurance payors. Serves as a subject matter expert of complex contracts, payor requirements, CMS coverage regulations and related billing practices, and governing transplant regulations and policies regarding solid organ transplantation. The Transplant Financial Coordinator advises patients on the complexities of solid organ insurance benefits and informs patients of the prior authorization/referral requirements. Operates as a resource to patients and their families, clinical staff, physicians, MUSC's managed care, billing teams and insurance companies. Responsible for the administrative/financial clearance decision to list a patient for solid organ transplantation. The TFC position serves as part of a multidisciplinary team charged with the responsibility of providing accurate financial evaluations and analysis as well as determining financial risk involved for MUSC, transplant physicians, and patients seeking transplant services. This includes determining the patient's benefits available for evaluation, pre-transplant maintenance, and transplant admission, obtaining inpatient and outpatient authorizations for hospital and physician services, and ensuring that necessary communication occurs between the payor, and MUSC for appropriate and accurate billing and reimbursement of services. Responsible for ensuring the accuracy of financial charges and reimbursement. This individual will utilize Epic, Excel, external private and governmental databases to analyze and facilitate efficient processing of claim reimbursement. Performs duties with a significant degree of independent judgement and decision making due to the extensive level of coordinating and managing all aspects related to insurance benefit information, authorization, billing and collections for each type of transplant service performed. Creates bundled global periods, works with managed care and the revenue cycle to ensure payment and assist in trouble shooting problems. Correctly notifies billing staff of accurate account disposition to match appropriate single case agreements and accurate contractual guidelines.

Additional Job Description

Additional Job Description Bachelor degree from an accredited university and two years of healthcare experience or high school diploma and 5 years of job experience in referral management, oncology navigation or patient access. In addition, the applicant must have considerable knowledge of complex medical terminology, strong interpersonal skills, ability to establish and maintain collaborative relationships both internally and externally, strong organizational skills, ability to rapidly prioritize/reprioritize, strong verbal and written communication skills, ability to work autonomously and in teams, critical-thinking skills, and ability to multi-task. If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet designated hospitals in South Carolina.