Review benefit requirements and start the request for authorization approval for the transplant evaluation, admission, clinic visits, work-up and testing, organ procurement, and post-transplant services.
Review benefit requirements and start authorization, pre-certifications and /or pre-determinations for treatments
Review benefits for appropriate coverage for services. Review contracts and obtain clarification from contracting as needed.
Meet with patients and family members at the time of transplant evaluation; explain to the patients the anticipated costs of transplant services and patient responsibilities (i.e. post-transplant meds); help patients and families create a financial plan when benefits are not sufficient to cover transplant costs.
Coordinate with Intermountain Contracting Services to create single case agreements for self-funded or international patients.
Coordinate with Intermountain transplant clinical teams, social workers, etc, the patients financial situation, expected coverage and out of pocket expenses, additional funding sources as well as any potential concerns.
Interact with transplant clinical staff and patients to obtain patient demographics to begin the insurance verification process.
Provide continuous financial counseling based on the patient’s benefits and calculate the estimated post insurance expenses for the patient.
Follows transplant policies and procedures as they relate to obtaining the financial approval.
Coordinates these policies and procedures and works closely with the transplant billing team to ensure compliance.
Help coordinate referrals to external transplant programs when the patient’s insurance is out of network.
Review and resolve any issues related to the patient’s insurance coverage.
Additional duties as assigned by management.
High School Diploma/GED
2 years’ experience as a Financial/Eligibility Counselor or 2 years of health insurance related experience (billing, authorizations, etc.).
5 years customer service experience in a healthcare or financial related field
Demonstrated outstanding public relations and interpersonal skills by maintaining supportive interpersonal relationships with caregivers, patients, families, sponsors and team members.
Multi-tasker, able to complete work timely and accurately.
Self-starter and team oriented, flexibility to adapt to change, ability to work with minimal supervision.
Excellent customer service skills exhibiting good oral and written communication skills.
Moderate computer skills (internet, email, MS Office) obtained from prior work experience.
Bachelor’s degree in a health care related field or business.
Bi-lingual (Spanish preferred).
Finance or Accounting experience.
Knowledge of Windows-based office software, computers and operating systems.
See, read, and/or operate computers, telephones, office equipment, documents, labels, including manipulating paper requiring the ability to move fingers and hands.
Remain sitting, standing, or walking for long periods of time to perform work on a computer, telephone, or other equipment.
Frequent interactions with associates, patient care providers, patients, and visitors that require associate to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information banding patients, etc.
Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items (over 50 lbs.).
Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.
Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including:
· Comprehensive Medical, Dental, Vision & RX Coverage
· Paid Time Off, Volunteer Time & Holidays
· 401K with Company Match
· Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability
· Tuition Reimbursement
· Parental Leave
R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.
If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.
To learn more, visit: R1RCM.com