Transplant Financial Navigator & Reimbursement Specialist

MedStar Health; Washington (District of Columbia); On-site; USD 60,000 - 102,000; Full time

Job summary

Georgetown University Hospital in Washington, DC seeks a Transplant Reimbursement Specialist to optimize patient insurance coverage and maximize reimbursement for transplant services. You will coordinate with payors, educate patients, and work across hospital departments to ensure timely, accurate financial processing.

The role involves analyzing coverage, guiding families through insurance options such as COBRA, and developing policies to streamline reimbursement processes.

Qualifications

• 3–5 years work experience in patient billing and/or insurance claim verification.
• Experience with claim processing / reimbursement utilization review or case management preferred.
• Licenses and Certifications: N/A

Responsibilities

• Evaluate insurance status, benefits, and resources to maximize reimbursement.
• Verify benefits and determine need for deposits, co-pays, and deductibles with payors.
• Interview candidates to determine insurance coverage and eligibility for programs.
• Develop and update reimbursement policies and resource materials.
• Maintain relationships with agencies offering financial aid for patients.
• Collaborate with transplant team and hospital departments on pre-admission requirements.
• Prepare individualized financial packets and explain them clearly to candidates.
• Use PMAS to update insurance/guarantor data and share information with staff.

Skills

Interpersonal communication

Customer relations

Organizational skills

Teamwork

Stress management

Problem solving

Education

Associate's degree in Health Services Administration or related field

Bachelor's degree in Health Services Administration or related field (preferred)

Job description

Georgetown University Hospital in Washington, DC seeks a Transplant Reimbursement Specialist to optimize patient insurance coverage and maximize reimbursement for transplant services. You will coordinate with payors, educate patients, and work across hospital departments to ensure timely, accurate financial processing.

The role involves analyzing coverage, guiding families through insurance options such as COBRA, and developing policies to streamline reimbursement processes.