Transplant Financial Navigator

University of Maryland Medical System; Baltimore (MD); On-site; USD 55,000 - 75,000; Full time

Job summary

University of Maryland Medical Center seeks a Financial Counselor to support care coordination and outpatient billing. You will verify insurance coverage, determine eligibility, and help patients navigate authorization and reimbursement processes.

Working with the MAE/FA team and care coordination staff, you will document actions in the EHR, coordinate with payers, and identify opportunities to improve authorization rates and reduce denials.

Qualifications

• Knowledge of insurance verification and hospital registration and EMR systems.

Responsibilities

• Verifies insurance benefits and coverage by contacting insurance companies and discusses responsibility with clients.
• Notifies case manager about clinical testing updates and patient admissions/discharges; schedules outpatient visits/tests/procedures.
• Educates patients on insurance coverage and hospital billing requirements.
• Identifies and resolves insurance barriers and assists with charity or financial aid programs when available.
• Assesses patients for presumptive charity, financial assistance, and Medical Assistance.
• Reviews patient accounts to gather information for MAE/FA team to aid authorization decisions.
• Communicates coverage issues to care coordination/outpatient center staff and assists in resolution.
• Develops and maintains financial reference guides and payer policy updates.
• Participates in Care Coordination/Outpatient Center team meetings to discuss payer requirements.
• Documents key steps in the authorization process in the EHR and maintains payer records.
• Develops letters of necessity with medical staff to maximize authorization and reimbursement.
• Develops and maintains workload reports and assists with staffing coverage.

Skills

Insurance verification

EMR systems

Word processing

Database software

Data reporting

Growth development

Education

Bachelor's degree in business or related field

High school diploma or GED

Tools

Epic registration

Job description

University of Maryland Medical Center seeks a Financial Counselor to support care coordination and outpatient billing. You will verify insurance coverage, determine eligibility, and help patients navigate authorization and reimbursement processes.

Working with the MAE/FA team and care coordination staff, you will document actions in the EHR, coordinate with payers, and identify opportunities to improve authorization rates and reduce denials.