Part time - 20 hours per week

On Site - Lebanon, NH

The Transplant Financial Coordinator reviews all new patient referrals for insurance suitability for transplantation; meets with each patient at the time of the initial appointment to review insurance and medical payments, reviewing both out of pocket and those costs billable to the patients’ insurance company.  The Transplant Financial coordinator discusses options for covering costs. This role also guides or counsels the patient in the application process for a wide range of Medicare, Medicaid and private insurance carriers. The Transplant Financial Coordinator also has responsibilities related to financial status of the transplant program.

1. Performs detailed benefit investigation for all patient referrals to ensure DH is in-network with the patient’s plan prior to patient acceptance in the DH Kidney Transplant Program. Counsels patients with out-of-network insurance on in network options.
2. Informs patients of detailed insurance coverage relating to all aspects of the transplant process. Explores fund raising and alternate funding options available to eliminate financial barriers when possible. Advises patients regarding choices of insurance coverage to best meet their individual needs, i.e., COBRA, Medicare/Medicaid eligibility, Medicare Supplemental Plans, and Medicare Advantage Plans.
3. Provides detailed information regarding End-Stage Renal Disease (ESRD) Medicare coordination of benefits rules and financial risk should they not enroll. Counsels and assists patient enrollment in ESRD Medicare at the appropriate time to prevent patient from becoming inadvertently uninsured.
4. Develops and maintains patient education and resource materials to keep current with industry and regulatory standards.
5. Solves issues that prohibit patients from accessing critical medications by working with pharmacies and insurance companies to resolve claims. Assists with locating pharmacies that have stock of critical transplant medications during periods of product shortages.
6. Maintains knowledge of available grant program criteria and connects patients as appropriate, such as HealthWell, PAN, American Kidney Foundation, while assisting the application process.
7. Tracks enrolled waitlist patients for the American Kidney Foundation and takes over management from the dialysis unit upon transplant.
8. Ensures compliance with memorandum of understanding (MOA) with the Knights of Columbus Medication Assistance, screens and approves patients for grant funding, maintains record of funds dispersed.
9. Coordinates and leads team discussion to determine use of Shaun Harington Fund grant to support various patient needs to facilitate access to transplant. Maintains record of funds dispersed.
10. Prepares and submits payment requests to accounts payable. Maintains knowledge of contract terms, insurance plan requirements including network status, authorization, and billing processes.
11. Maintains current knowledge of federal and transplant industry regulations to ensure the transplant program financial activities are in compliance.
12. Analyzes and audits bills for transplant department purchased services; codes and submits to accounts payable to capture all cost reportable items for inclusion on the cost report.
13. Manages End-Stage Renal Disease Quality Reporting System (EQRS) process, ensures timely data submission
14. Participates in transplant program multi-disciplinary and/or other patient management meetings and provides pertinent financial information that may affect the patient’s suitability as a transplant candidate. Provides the team with input on how transplant care options financially impact both the patient and DH.
15. Analyzes and acts upon third-party benefit discrepancies prior to billing. Attends transplant financial meetings and acts as a subject matter expert to the group. Tracks insurance billing and payment for each transplant case. Reports out to the Transplant Administrator, facilitating tracking of trends to assess opportunity for revenue and process improvements.
16. Leads projects related to transplant financials from inception to completion. Attends local, national, and international meetings and conferences to remain current regarding issues relevant to the performance of transplant financial management.
17. Performs other duties as required or assigned.

• Bachelor’s degree or equivalent of 5 years of systems experience
• 5 years of insurance verification/authorization, billing, and follow-up.
• Minimum 3 years providing direct patient education of insurance coverage and benefits.
• Excellent computer skills, including proficiency with Microsoft Office products including Outlook, Excel, Word and Power Point
• 3-5 years of experience working in D-H system preferred
• Excellent written and verbal communication skills.
• Excellent interpersonal skills with the ability to adapt to individual patient learning needs.
• The ability to work independently with a high degree of tact, discretion, and professionalism.
• High-level problem-solving skills with the ability to strategize and coordinate patient care with multiple team members including physicians and administrators.
• Knowledge of general medical terminology, anatomy, and pathology.
• Prior knowledge of Dartmouth Hitchcock payor contracts as related to transplant reimbursement and billing issues preferred

• Obtain certification as a Transplant Financial Coordinator within 2 years of hire.
• Maintain membership with the Transplant Financial Coordinators Association