Transplant Financial Coordinator - Hybrid

Brigham and Women's Hospital; Boston (MA); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Brigham and Women's Hospital is seeking a Transplant Financial Coordinator to manage financial aspects of patient care throughout the transplant process. This role involves assessing financial resources, coordinating with insurance providers, and providing guidance to patients and families to ensure continuity of care. Ideal candidates will have strong communication skills and experience working in healthcare insurance.

Qualifications

• 1-2 years of experience with healthcare insurance benefits.
• Demonstrated experience working with patients and families.
• Knowledge of organ transplantation processes preferred.

Responsibilities

• Coordinate financial aspects of care throughout the transplant process.
• Assist patients with insurance and funding options.
• Monitor insurance data and verify coverage for transplant services.

Skills

Attention to Detail

Interpersonal Skills

Communication

Education

High School Diploma

Bachelor's Degree

Tools

Epic

Microsoft Office

Job description

Transplant Financial Coordinator - Hybrid

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Transplant Financial Coordinator - Hybrid

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Join to apply for the Transplant Financial Coordinator - Hybrid role at Brigham and Women's Hospital

Site: The Brigham and Women's Hospital, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Brigham is a global leader, devoted to maintaining and restoring health for people everywhere. Brigham is composed of Brigham and Women’s Hospital (BWH), Brigham and Women’s Faulkner Hospital (BWFH), and Brigham and Women’s Physicians Organization (BWPO).

Brigham is an academic medical center with a firm commitment to its tripartite mission. From the clinical standpoint, Brigham serves patients from New England, throughout the United States, and from 120 countries around the world. These clinical services are supported at 2 hospitals and 150 outpatient practices, by more than 1,200 physicians. From the research standpoint, Brigham conducts the second largest hospital-based research program in the world, with an annual research budget of more than $630 million. And from the education standpoint, Brigham is a training ground for physicians, nurses, and allied health professionals. We have 1,100 trainees in over 140 of the most sought-after training programs in the world and also host Harvard Medical School students in rotations throughout our programs.

Brigham is an internationally recognized leader in transplantation services, providing advanced care for a wide spectrum of organ and tissue transplants, including kidney, pancreas, Renal, heart, face, hand, and bone marrow. Many transplant milestones have taken place here, including the world’s first successful human organ transplant, a kidney transplanted in 1954. Since this groundbreaking start, our transplant programs have continued to build upon this innovative spirit, and currently perform ~150 transplants each year.

The Financial Coordinator is a member of the multidisciplinary transplant team and has primary responsibility for coordinating financial aspects of care throughout all phases of the transplant process. The Financial Coordinator supports the Center for Advanced Heart disease which includes Heart Transplant, VAD (bridge to transplant/destination therapy) and heart failure care.

Qualifications

The Financial Coordinator acts as a resource and financial counselor for transplant candidates and their families, providing financial guidance in a compassionate and tactful manner in order to help facilitate access and provide continuity of care. The Financial Coordinator works extensively with the transplant team members, third party payers, government agencies, other funding agencies and hospital financial/billing staff. He/she facilitates transplant billing and provides quality service to patients by providing comprehensive and ongoing financial counseling and by identifying and helping to resolve financial coverage issues.

Overall duties

• Meets with potential transplant patients to assess financial means and needs, and provide financial information and resources as needed. Assists with financial planning.
• Obtains detailed patient insurance benefit information and assists with verification of coverage relating to all aspects of the transplant process, including but not limited to: evaluation, transplantation, outpatient prescription drug benefits, post-transplant services, out-of-pocket maximums, and travel and housing if necessary. Determines co-payment expectations and other potential out-of-pocket liability.
• Serves as a resource for patients and family members on financial matters throughout the transplant process. Works with patients, their families, and transplant team members to address insurance coverage gaps and issues and investigates alternative funding options as necessary.
• Advises transplant candidates on insurance and funding options including providing information regarding alternate funding and choices of insurance coverage i.e., Medicare and Medicaid eligibility, COBRA, Social Security Disability, retirement plans, etc. Provides information to patients regarding available medication assistance programs and assistance with co-payments, and organizations that can assist with fund-raising. Assists with applications, eligibility guidelines and other necessary paperwork or process issues to access such assistance.
• Keeps apprised of changes in federal and state (FDA/HFCA, etc.) guidelines and policies related to organ transplantation.
• Obtains all necessary payer authorizations, verifies transplant coverage and other medical benefits as needed for pre/post transplant and VAD patients.
• Monitors and updates information regarding insurance data, authorizations, and preferred providers on a regular basis. Follow-ups with patients throughout the transplant process as necessary for financial needs.
• Working with hospital staff and division finance/billing staff, facilitates resolution of patient billing issues.
• Keeps clinical staff informed of all patient financial information and alerts staff to any issues that may impact patient’s ability to undergo services during the transplantation process.
• Serves as a routine resource to the Transplant team and provides explanation to the clinical and administrative staff in regard to transplantation reimbursement criteria and insurance coverage.
• Participates in transplant program multi-disciplinary and/or other patient management meetings and is prepared to provide pertinent financial information.
• Responsible for managing the charge router and organ acquisition work queues in EPIC.
• Participates in patient orientation sessions and/or other patient information forums as required.
  
  

Transplant Service Line

• Monitor provider enrollment.
• Sends out weekly open encounter reports to ensure encounters are closed in a timely manner.
• Acts as a billing coordinator to support coding and billing inquiries.
• Maintain financial and denial WQs and reports.
• Cross coverage includes review of all clinics a week in advance to ensure a referrals and authorizations are on file for pre and post-transplant patients.
  
  

Administration

• Send out patient financial overview via epic or mail
• Documents patient calls and status updates in epic
• Monitor the shared outlook mailbox and have a response rate of 24-48 hours to emails
• Scan in authorization responses from payers in epic
• Upload appropriate documents into epic and or payer websites/portals
• Run reports daily or weekly in epic
• Join and participates in recurring team meetings
  
  

Other

• Participates in quality assurance and process improvement projects as appropriate.
• Participates in relevant special projects.
• Performs other duties as assigned and/or required.
  
  

Education

• High School Diploma requires
• Bachelors Degree a plus!
  
  

Experience

• 1-2 years of direct experience with healthcare insurance benefits, preferably in a hospital setting. Experience with transplant financial issues and/or insurance coverage a strong plus.
• Demonstrated strong experience working effectively with patients, doctors and nurses.
• Experience with transplant financial issues and/or insurance coverage a strong plus
  
  

Knowledge, Skills And Abilities

• Ability to work effectively in a team and multi-disciplinary environment
• Strong attention to detail and organization.
• Must have the ability to work independently, follow up on tasks, and use judgement.
• Must be a “team player” and enjoy working with people both on the telephone and in-person; ability to deal effectively with difficult people.
• Excellent interpersonal and communication (oral, written, e-mail, grammar) skills necessary.
• Excellent computer skills; proficient with Microsoft Word, Excel, PowerPoint.
• Knowledge of the patient access processes (i.e. admitting, pre-op, registration).
• Medical terminology knowledge a must.
• Ability to work effectively in a team and multi-disciplinary environment.
  
  

Licenses and Credentials

No

Working Conditions

• Work in an office setting
• Hybrid model
  
  

Supervisory Responsibility

NA

Fiscal Responsibility

• Support fiscal ending activities (financial WQs)
  
  

Additional Job Details (if Applicable)

OTHER DUTIES AND RESPONSIBILITIES

• Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as established by BWH/Partners
• Follows safe practices required for the position.
• Complies with appropriate BWH and Partners policies and procedures.
• Fulfills any training required by BWH and/or Partners, as appropriate.
• Brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital.
  
  

Physical Requirements

• Standing Occasionally (3-33%)
• Walking Occasionally (3-33%)
• Sitting Constantly (67-100%)
• Lifting Occasionally (3-33%) 20lbs - 35lbs
• Carrying Occasionally (3-33%) 20lbs - 35lbs
• Pushing Rarely (Less than 2%)
• Pulling Rarely (Less than 2%)
• Climbing Rarely (Less than 2%)
• Balancing Occasionally (3-33%)
• Stooping Occasionally (3-33%)
• Kneeling Rarely (Less than 2%)
• Crouching Rarely (Less than 2%)
• Crawling Rarely (Less than 2%)
• Reaching Occasionally (3-33%)
• Gross Manipulation (Handling) Constantly (67-100%)
• Fine Manipulation (Fingering) Frequently (34-66%)
• Feeling Constantly (67-100%)
• Foot Use Rarely (Less than 2%)
• Vision - Far Constantly (67-100%)
• Vision - Near Constantly (67-100%)
• Talking Constantly (67-100%)
• Hearing Constantly (67-100%)
  
  

Remote Type

Hybrid

Work Location

75 Francis Street

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

EEO Statement

The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Hospitals and Health Care

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