Transplant Nurse Coordinator jobs in Wilmington, DE

ChristianaCare's Kidney Transplant Program is looking to hire a Full time Financial Coordinator to support the team.

The Transplant Financial Coordinator is an advocate on behalf of patients and families and is responsible for obtaining detailed patient insurance benefit and related financial information for all aspects of the transplant process, including but not limited to, the evaluation, inpatient transplant surgery, prescription drugs and follow-up outpatient visits as well as living donors in all phases of care. The Transplant Financial Coordinator together with other appropriate interdisciplinary team members is also responsible for ensuring appropriate authorizations are obtained and documentation is prepared to allow for appropriate billing for all charges. Experience with Medicare, insurance verifications and obtaining prior authorizations is highly preferred.

Work Schedule:

• Monday- Friday: 7:30am- 4:00pm, flexible work hours available.

• No weekends or holidays.

• Opportunity for great work-life balance!

Key Responsibilities

• Functions as the primary resource for patients that have questions related to insurance coverage and related financial matters for the transplant program.

• Advocates for patients and family members and acts as a liaison with insurance companies to assist in obtaining insurance information.

• Advocates for patients and family members and acts as a liaison with End Stage Renal Disease (ESRD) providers and Network 4 to assist in obtaining Medicare coverage. Identifies and facilitates the submission of required documentation to Social Security and ESRD Network 4 for appropriate patients.

• Researches and documents all insurance plans and confirm patients benefit eligibility, including patient liabilities, clauses, riders and secondary payors.

• Provides information to the appropriate billing specialist to ensure accurate billing for current and future services.

• Reviews and interprets insurance group pre-certification requirements. Ensures proper pre-authorizations have been obtained. Completes any necessary on-line operations for specific payors to complete the pre-certification process. As necessary communicates data to utilization management to continue medical review process.

• Coordinates the ongoing pre-certification and approval process with insurance case managers and assist case managers with discharge planning in order to coordinate the most appropriate level of care for patients.

• Obtains referral from patients Primary Care Physician prior to admission for managed care plans when applicable.

• Handles all transplant related insurance questions and when necessary obtains information from various sources including but not limited to clinics, physicians, patients, attorneys, employers, payors and other outside agencies.

• Maintains up to date records on a daily, weekly and monthly basis of all accounts pending verification reviews, utilizing transplant database lists and take appropriate action to resolve accounts.

Benefits & Incentives

• Full Medical, Dental, Vision, Life Insurance, etc.

• Two retirement planning offerings, including 403(b) with company contributions.

• Generous paid time off with annual roll-over and opportunities to cash out.

• 12 week paid parental leave.

• Tuition assistance

• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets, insurance and much more!

Qualifications:

• Minimum of a high school diploma or equivalent.. Associate degree in business or healthcare field with course work in accounting, business and/or health care administration preferred.

• 1-3 years of finance experience required, healthcare setting preferred. Transplant experience a plus.

• Extensive knowledge and comprehension of insurance standards and regulations required.

• Managed care experience and related experience with third party payor processes related to inpatient, outpatient and physician billing and specialized documentation requirements relating to transplant coverage a plus.

Interested candidates should attach an updated copy of their resume during the application process.

Why ChristianaCare

ChristianaCare is rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America's 50 Best Hospitals and continually ranked among the nation's best by U.S. News & World Report, Newsweek and other national quality ratings.

Whether a position can be supported for remote work will be assessed based on whether ChristianaCare is able to meet the business requirements of the proposed remote location.

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Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.