Transplant Financial Coordinator-Kidney Transplant
Summary Position Summary This position is responsible for ensuring that insurance coverage is available and determines the scope of the patients benefits prior to services being rendered.
This position is also responsible for obtaining necessary referrals, authorizations and pre certifications.
Comprehensive knowledge of State and Federal agencies including MaineCare & Medicare regulations.
In addition, the Financial Counselor needs to have a general knowledge of ICD diagnosis codes, CPT codes to assist patients and third party payors in the resolution of complex authorization/billing issues.
The incumbent will act as a liaison and coordinate communication between clinical coordinators, physicians, social workers, utilization review coordinators, patients, patient representatives and third party payors.
This position requires an advanced level of customer service, analytical and organizational skills in order to maintain a high level of production in an extremely stressfull and task driven environment.
The ability to function as part of a team is critical to the success of the Financial Counselor and the department.
An associate degree is required; a bachelor's degree is preferred.
Two to five years of experience in a hospital/clinical environment and two to five years experience in customer service.
Required Minimum Knowledge, Skills, and Abilities (KSAs) Education:
Associates degree is preferred.
License/Certifications:
N/A
Experience:
Two to five years of experience in a hospital/clinical environment and two to five years experience in customer service.
Must have a clinical background in order to review clinical documentation prior to proceeding with the authorization process with third party payors.
Must have strong verbal communication/interpersonal skills to deal effectively with patients, patient representatives, third party payors and colleagues with varying professional backgrounds in the resolution of third party payor reimbursement.
Comprehensive knowledge of State and Federal agencies including MaineCare & Medicare regulations.
In addition the Financial Counselor level II needs to have a general knowledge of ICD-9 diagnosis codes, CPT codes, UB92/UB04 billing forms and HCFA 1500 billing forms, needed to assist patients and third party payors in the resolution of complex authorization/billing issues.
Must consult with patients, patient representatives to fully understand patient's individual insurance benefits in order to obtain the appropriate referrals, authorizations and pre-certifications.
Ability to interact with Patient Accounts, Admitting and Physician offices regarding any issues with the authorization process, demographic/insurance updates and to identify other financial resources that may be available to patients.
Ability to comprehend departmental and institutional policies and procedures including, HIPPA confidentiality laws and how the laws pertain to interactions amongst patient, peers, and colleagues is mandatory.
Additional Information With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential.
If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.
Additional Information Maine Medical Center is a Magnet designated 700-bed tertiary care and teaching institution.
MMC is Maine's largest hospital and a state-wide health care resource.
MMC offers outstanding career opportunities and quality of life in Portland.
Recommended Skills Billing Cpt Coding Clinical Works Communication Confidentiality Coordinating Estimated Salary: $20 to $28 per hour based on qualifications.
This position is also responsible for obtaining necessary referrals, authorizations and pre certifications.
Comprehensive knowledge of State and Federal agencies including MaineCare & Medicare regulations.
In addition, the Financial Counselor needs to have a general knowledge of ICD diagnosis codes, CPT codes to assist patients and third party payors in the resolution of complex authorization/billing issues.
The incumbent will act as a liaison and coordinate communication between clinical coordinators, physicians, social workers, utilization review coordinators, patients, patient representatives and third party payors.
This position requires an advanced level of customer service, analytical and organizational skills in order to maintain a high level of production in an extremely stressfull and task driven environment.
The ability to function as part of a team is critical to the success of the Financial Counselor and the department.
An associate degree is required; a bachelor's degree is preferred.
Two to five years of experience in a hospital/clinical environment and two to five years experience in customer service.
Required Minimum Knowledge, Skills, and Abilities (KSAs) Education:
Associates degree is preferred.
License/Certifications:
N/A
Experience:
Two to five years of experience in a hospital/clinical environment and two to five years experience in customer service.
Must have a clinical background in order to review clinical documentation prior to proceeding with the authorization process with third party payors.
Must have strong verbal communication/interpersonal skills to deal effectively with patients, patient representatives, third party payors and colleagues with varying professional backgrounds in the resolution of third party payor reimbursement.
Comprehensive knowledge of State and Federal agencies including MaineCare & Medicare regulations.
In addition the Financial Counselor level II needs to have a general knowledge of ICD-9 diagnosis codes, CPT codes, UB92/UB04 billing forms and HCFA 1500 billing forms, needed to assist patients and third party payors in the resolution of complex authorization/billing issues.
Must consult with patients, patient representatives to fully understand patient's individual insurance benefits in order to obtain the appropriate referrals, authorizations and pre-certifications.
Ability to interact with Patient Accounts, Admitting and Physician offices regarding any issues with the authorization process, demographic/insurance updates and to identify other financial resources that may be available to patients.
Ability to comprehend departmental and institutional policies and procedures including, HIPPA confidentiality laws and how the laws pertain to interactions amongst patient, peers, and colleagues is mandatory.
Additional Information With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential.
If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.
Additional Information Maine Medical Center is a Magnet designated 700-bed tertiary care and teaching institution.
MMC is Maine's largest hospital and a state-wide health care resource.
MMC offers outstanding career opportunities and quality of life in Portland.
Recommended Skills Billing Cpt Coding Clinical Works Communication Confidentiality Coordinating Estimated Salary: $20 to $28 per hour based on qualifications.
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