Job Description

Reporting to the Supervisor of Transplant Financial Coordination, the Transplant Financial Coordinator will be responsible for providing financial services for heart transplant, kidney transplant, bone marrow transplant, and VAD patients. The position will be the patient’s Tufts MC point of contact for all medical insurance and authorization concerns. The position is responsible for obtaining medical authorizations and serving the patient with financial counseling. The position will also report back to the multidisciplinary team.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Meets with the patient and his/her family during the transplant/VAD evaluation process to review the patient’s insurance(s), insurance requirements, etc. Serves as patient liaison for financial matter throughout transplant/VAD process.
• Verifies insurance, checks benefits, obtains authorization(s), obtains referral(s), notifies the payer of admission, obtains patient responsibility from payer, etc.
• Collects patient responsibility pre-service. Establishes payment plan, if necessary.
• Takes and passes annual exam to be a MassHealth Certified Application Counselor.
• Working with the patient, completes, files, and follows to resolution applications for Massachusetts Medicaid, including disability, Health Safety Net, and other such programs.
• Refers patients to programs where Hospital staff cannot file directly for the patient, including Veteran's Services, and EAEDC.
• Works closely with and communicates consistently with Social Work, Case Management, Billing, Contracting, and Transplant Coordinators to provide a cohesive support system to the patient and the clinical providers.
• Stays abreast of regulations, making certain that applications are appropriate and complete to ensure that the Hospital, the professional groups, and the patient receive all benefits for which the patient is eligible.
• Documents all meeting minutes and steps taken on an account. Tracks every account.

Qualifications

JOB KNOWLEDGE AND SKILLS:

• Level knowledge generally acquired through completion of a Bachelor's degree with courses in business management or social sciences or comparable experience.
• Two to three years experience in a community service environment such as a Hospital or Welfare Agency.
• In-depth knowledge of medical terminology and its relationship in establishing certifiable disabilities.
• Excellent interpersonal skills required to interact effectively with patients, their families, the medical staff, QSS, and other departments within the facility, as well as many outside agencies.
• Ability to grasp, retain, and apply new regulations and procedural changes both within the institution and to outside agencies.
• Complete understanding in the application of health insurance benefits to hospital and professional charges.
• Ability to handle stressful situations involving critically ill patients and other sensitive issues which involve finances.
• Good written communication skills.
• Excellent systems skills. Ability to work in a complex systems environment and understand spreadsheets and other business technologies.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Constant contact with patients, patient families, and medical staff.
• There are some occasions when patients are on precautions and a gown and mask must be worn when interviewing. There are other situations when patients may be violent and the correct approach by the Coordinator is invaluable, when trying to extract financial information.

Additional Information

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.