NYU Langone is one of the nation's premier academic medical centers that includes five hospitals (Tisch Hospital, Rusk Rehabilitation, Hospital for Joint Diseases, Hassenfeld Children's Hospital of New York, and NYU Lutheran Medical Center) and more than 200 ambulatory locations across the New York metropolitan area. It also includes NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. Our trifold mission to serve, teach, and discover is achieved daily through an integrated academic culture devoted to excellence in patient care, education, and research. Learn more about NYU Langone.
Position Summary: We have an exciting opportunity to join our team as a Transplant Financial Coord.
In this role, the successful candidate The Transplant Financial Coordinator (TFC) is a designated member of the multidisciplinary transplant team, and is responsible for coordinating and clarifying patient-specific financial aspects of care. The TFC works with patients and their families beginning with the evaluation for transplantation and continuing through and after transplantation, in a compassionate and tactful manner, in order to help facilitate access to and provide continuity of care. The TFC will also work with other members of the transplant team, insurers, administrative, billing, financial and clinical personnel at NYULMC to ensure financial coverage of transplant and living donor services.
Obtains and documents detailed patient insurance benefit information for all aspects of the transplant process, including, but not limited to, transplant surgery, outpatient prescription drugs, organ acquisition, follow-up clinic visits, and travel and housing if necessary.
Discusses benefits and other transplant financial issues with patients and/or family members during initial evaluation. Advises patients on insurance and billing issues and options. Serving as a resource for patients and their family members on financial matters. Provides patients with educational materials about the financial considerations of transplantation and information about financing options and insurance coverage.
Obtains all necessary payor authorizations. Verifies transplant coverage and other medical benefits and acquiring necessary referrals and authorizations for inpatient stays and procedures. Assists with financial clearance of urgent inpatient transfers of critical patients. Monitors insurance coverage for patients throughout the period that they are waiting for a transplant. Assists patients with questions concerning insurance and other financial issues.
Identifies and effectively communicates financial information to transplant team members, patients and their families with emphasis on identifying any potential patient out-of-pocket liability. Establishes relationships with insurance company case managers and medical directors to facilitate insurance approvals.
Works with patients, their families and team members when possible to help address insurance coverage gaps via alternative funding options. Assists patients with the application process for government or other financial assistance programs working with the institution Financial Coordinators (i.e. Medicaid, charity, payment plans, etc.) if a patient is self-pay or insurance benefits do not cover the hospital services.
Facilitates resolution of patient billing issues. Serves as a liaison with the NYULMC professional fee and hospital billing offices to resolve billing questions and issues. Communicates data to NYULMC Utilization Management Department to assist with the medical review process.
Collaborates with the NYULMC Office of Managed Care to obtain single case agreements, or other arrangements with patient insurance companies, in order facilitate transplant coverage. Assists with proper identification of and accounting for global contract cases.
Maintains familiarity with UNOS and CMS regulations related to transplant finance and billing practices. Follows NYULMC policies and procedures.
Assists with review of claims to determine if they are appropriate for payment from organ acquisition or by a patients insurance company.
Participates in the weekly Transplant Selection Committee meetings to represent financial aspects of transplant candidates. Prepares financial reports on each patient prior to the meeting, and answers questions about finances at the meeting.
Minimum Qualifications: To qualify you must have a Bachelors degree. At least two years of experience in healthcare financial coordination or counseling, or an equivalent combination of education and experience is also acceptable. Evidence of good interpersonal skills, effective communication skills and creative problem solving. Ability to analyze and update accounts via electronic systems.
Preferred Qualifications: Four years of healthcare customer service and/or health insurance experience. Prior transplant experience. Knowledge about resources or assistance programs for which uninsured patients may be eligible. Experience in financial counseling and/or insurance reimbursement.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Medical Center is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Medical Center's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
NYU Langone Medical Center, a world-class patient-centered integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of... only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.NYULMC.org.