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The Enterprise Transplant Financial Coordinator is an advanced level authorization representative with advanced knowledge of all solid organ and BMT pre-transplant and post-transplant processes. The position has a thorough understanding of payer requirements related to referral, precertification, prior authorization and/or financial clearance.
Courteously and professionally complete financial clearance calls works with patients to outline financial obligations related to care, and provides options for patients to meet financial requirements, including assessing financial assistance eligibility, determining insurance coverage eligibility, and providing estimates
Regularly monitor work queues to ensure authorizations are completed timely and escalate potential barriers or delays.
Answer and resolve inbound Transplant Call Center calls timely and efficiently.
This role requires interpretation of insurance coverage eligibility, insurance transplant contracts, and the submission of Letter of Agreement (LOA) and Individual Case Negotiation (ICN) requests to address any in/out of network coverage or self-pay issues.
This position may participate or provide information for in selection committee meetings with the Transplant Team from a financial aspect to assist the committee's decision to accept/deny potential transplant recipients and the determination of the patient's transplant listing status.
This role may also include participation and collaboration with a the multidisciplinary care team in the development and implementation of protocol and standards of care planned for the transplant patient.
This position will be responsible for monitoring and the updating of necessary documentation according to the United Network of Organ Sharing (UNOS) and Centers for Medicare and Medicaid Services (CMS) guidelines that may include listing, status changes and post-transplant follow up information.
Assist with staff training and cross coverage as needed.
This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations.
Responsibilities include:
- Coordinating financial clearance for transplant-related services from intake through status determination
- Verifying insurance eligibility and interpreting transplant-specific benefits
- Initiating and supporting authorization and payer communication processes
- Communicating financial status, requirements, and next steps to internal teams
- Identifying barriers to financial clearance and taking appropriate action to resolve or escalate
- Maintaining accurate, detailed documentation to support continuity of work and compliance standards
- Following accounts through defined workflows to ensure completion of financial activities within scope
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
- Medical: Multiple plan options.
- Dental: Delta Dental or reimbursement account for flexible coverage.
- Vision: Affordable plan with national network.
- Pre-Tax Savings: HSA and FSAs for eligible expenses.
- Retirement: Competitive retirement package to secure your future.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
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