Business Financial Clearance Coordinator

• Performs financial screening/interviews of all patients via phone prior to presenting for clinical transplant consult.
• Researches and verifies insurance and benefits for hospital and professional coverage.
• Works with pharmacy to ensure pharmacy coverage and immunosuppressive medications are authorized by appropriate teams.
• Collects information from patient and determines benefits including what type of coverage may be obtained for the patient (i.e. Medicare, Medicaid, and spend-down information). Assists the patient/guarantor in obtaining other resources if eligibility has been terminated.
• Quotes co-payments, deductibles, and coinsurance, according to policy and contracts to patients/guarantors. Collects any out of pocket monies identified during benefits check. Obtains approval from management for various payment options that ensures compliance and minimized collection expenses.
• Supports the insurance referral process when coverage needs to be clarified, especially for out of network plans.
• Collects and submits necessary clinical documentation and correspondence for all pre-transplant service, transplant event, admission and post transplant authorizations.
• Participates in meetings with stem cell transplant department, on a as need basis to ensure coordination of clinical and financial information.
• Reviews daily EPIC reports and EPIC work queues to determine if the visit is stem cell transplant related, and requires financial clearance follow up.
• Updates appropriate EPIC flags, guarantor, registration, insurance (s), and authorization (s) appropriate billing indicators.
• Assists Patient Financial Services department with billing questions related to Stem Cell Transplant visits.
• Adheres to contractual guidelines and accepted payers and associated global billing periods with insurance companies when obtaining initial or continuing authorization for services.
• Make every effort to minimize the loss of reimbursement for lack of notification, lack of authorization, or denied days due to lack of continuing authorization. Analyzes denials where necessary to determine root cause.
• In addition to the above job responsibilities, other duties may be assigned.

MINIMUM REQUIREMENTS:

Education: High School Graduate or Equivalent, Bachelor's Degree preferred.

Experience: Two years' experience in financial counseling, insurance reimbursement and benefits, prior authorizations. Prior stem cell transplant experience preferred.

Licensure: None.

PHYSICAL DEMANDS

Job requires sitting for prolonged periods, attention to detail, must be able to hear, speak, read and write legibly.

The University of Virginia, including the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician's Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex, pregnancy, sexual orientation, veteran or military status, and family medical or genetic information.