Transplant Financial Coordinator - Abacus Service Corporation
Los Angeles, CA 90033
About the Job
Description:
Assignment Information
" Medical Enterprise:
" Cost Center: 1726-7032
" PCC: 19632
" USC Address where the work is being performed? 2011 N. Soto St, Los Angeles, CA 90033, 2nd Floor
" Will this position be virtual/remote, onsite, hybrid?100 % - On Site
" Job Title: Transplant Financial Coordinator
" Number of needs: 1
" Target start date: ASAP
" Duration of Assignment: 13 Weeks
" Contract to hire opportunity: No, not at this time this is coverage for FTE's who are on leave
" Work hours: 8:30am 5:00pm, M-F (30 minute lunch)
" Dress code: Business Casual
" Parking/Cost: Parking pass provided but this might take a few days to secure so pay will be out of pocket by the contingent worker.
SEE ATTACHED JOB DESCRIPTION
Top 3 Required Skills:
1. Insurance knowledge: Commercial and Public
2. Problem-Solving, Critical Thinking
3. Independent worker / Self-management
Top 3 Preferred Skills:
1. Quick learner
2. Computer Savvy (we use many online portals and 2 EMRs) knowledge of Microsoft Office: Word, Excel, Outlook, PowerPoint & Excel
3. Good Oral and Communicational skills
Top 3- 5 Daily Responsibilities:
1. Obtain transplant benefits
2. Submit authorization request via electronic fax or using an online portal
3. Follow up on authorization requests and communicate with a clinical team or schedulers, other tasks will apply to calling patients to obtain new ins or update insurance in 2 EMRs and communicate with the clinical team.
Medical Enterprise - Non-Clinical Onboarding
Background, Education and Employment
Background
Social Security Trace
7 years worked and lived found by SSN Trace
County Criminal F&M - 7 year
Federal Criminal - 7 year
Widescreen Plus National Criminal Search
National Sex Offender Registry
Healthcare Sanctions State
OIG/SAM
Education: HS Diploma (or equivalent GED)
Employment: 3 Employers Must verify 2 out of 3
Other Requirements
HIPAA
Application
Temporary Worker Agreement
Harassment & Discrimination Pamphlet
**Note: ALL IS BILLABLE EXCEPT FOR DRUG SCREEN
1. Bloodwork (Titers) to show they are immune to MMR (Measles, Mumps and Rubella), Varicella (Chickenpox) & Hepatitis B. In the event that they do not have this:
Provide proof they had injections (shot records):
MMR Series of 2
Varicella Series of 2
Hepatitis B series of 3
*MUST be fully vaccinated for:
MMR
Varicella
*Worker can decline HEP B (no exemption form required) Declination Form needs to be on file Supplier can provide own Hep B declination
2. TB Test(yearly)
Date test was done
Must have been read within 24 to 48 hours of the test
In case of positive TB history, must present chest x-ray results.
3. Drug Screen 10 panel
Drug Test Panel:
- AMPHETAMINES
- BARBITURATES
- BENZODIAZEPINES
- COCAINE METABOLITE
- OPIATES
- CODEINE
- MORPHINE
- HYDROCODONE
- HYDROMORPHONE
- OXYCODONE
- PHENCYCLIDINE
- METHADONE
- PROPOXYPHENE
4. Influenza for Current Flu Season: Flu shot is ONLY good for the season which is 11/1 through 4/30.
If they start on May 1st, they don't need the vaccine until next Fall. It is recommended for Workers to wait and get the vaccine AFTER Sept 1st. The facility accepts a signed personal/medical exemption.
5. COVID Vaccinations
Fully vaccinated with Covid-24-25 Vaccine. The facility accepts a signed religious/medical exemption.
*Exemption form accepted for:
COVID
FLU
***Qualified Applicants with arrest or Conviction records will be considered for Employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act
Attachment -
JOB DESCRIPTION
NOTE: Accountabilities % must add up to 100% and complete page 5-6
The above statements reflect the essential and non essential functions considered necessary to describe the principle contents of the job. They are not intended to be a complete statement of all work requirements or duties that may be inherent in the job.
I acknowledge receipt of a copy of this position document. I have read this job description and agree to abide by its contents. I realize the duties may be requested of me that are not specifically stated herein. I agree to perform these duties as directed by my supervisor. I understand that I will be expected to adjust to potential fluctuation in work volume. I understand that, if I have any questions about the essential functions or expectations of my position, my supervisor is available to discuss them with me.
Print Employee Name Signature Date
Assignment Information
" Medical Enterprise:
" Cost Center: 1726-7032
" PCC: 19632
" USC Address where the work is being performed? 2011 N. Soto St, Los Angeles, CA 90033, 2nd Floor
" Will this position be virtual/remote, onsite, hybrid?100 % - On Site
" Job Title: Transplant Financial Coordinator
" Number of needs: 1
" Target start date: ASAP
" Duration of Assignment: 13 Weeks
" Contract to hire opportunity: No, not at this time this is coverage for FTE's who are on leave
" Work hours: 8:30am 5:00pm, M-F (30 minute lunch)
" Dress code: Business Casual
" Parking/Cost: Parking pass provided but this might take a few days to secure so pay will be out of pocket by the contingent worker.
SEE ATTACHED JOB DESCRIPTION
Top 3 Required Skills:
1. Insurance knowledge: Commercial and Public
2. Problem-Solving, Critical Thinking
3. Independent worker / Self-management
Top 3 Preferred Skills:
1. Quick learner
2. Computer Savvy (we use many online portals and 2 EMRs) knowledge of Microsoft Office: Word, Excel, Outlook, PowerPoint & Excel
3. Good Oral and Communicational skills
Top 3- 5 Daily Responsibilities:
1. Obtain transplant benefits
2. Submit authorization request via electronic fax or using an online portal
3. Follow up on authorization requests and communicate with a clinical team or schedulers, other tasks will apply to calling patients to obtain new ins or update insurance in 2 EMRs and communicate with the clinical team.
Medical Enterprise - Non-Clinical Onboarding
Background, Education and Employment
Background
Social Security Trace
7 years worked and lived found by SSN Trace
County Criminal F&M - 7 year
Federal Criminal - 7 year
Widescreen Plus National Criminal Search
National Sex Offender Registry
Healthcare Sanctions State
OIG/SAM
Education: HS Diploma (or equivalent GED)
Employment: 3 Employers Must verify 2 out of 3
Other Requirements
HIPAA
Application
Temporary Worker Agreement
Harassment & Discrimination Pamphlet
**Note: ALL IS BILLABLE EXCEPT FOR DRUG SCREEN
1. Bloodwork (Titers) to show they are immune to MMR (Measles, Mumps and Rubella), Varicella (Chickenpox) & Hepatitis B. In the event that they do not have this:
Provide proof they had injections (shot records):
MMR Series of 2
Varicella Series of 2
Hepatitis B series of 3
*MUST be fully vaccinated for:
MMR
Varicella
*Worker can decline HEP B (no exemption form required) Declination Form needs to be on file Supplier can provide own Hep B declination
2. TB Test(yearly)
Date test was done
Must have been read within 24 to 48 hours of the test
In case of positive TB history, must present chest x-ray results.
3. Drug Screen 10 panel
Drug Test Panel:
- AMPHETAMINES
- BARBITURATES
- BENZODIAZEPINES
- COCAINE METABOLITE
- OPIATES
- CODEINE
- MORPHINE
- HYDROCODONE
- HYDROMORPHONE
- OXYCODONE
- PHENCYCLIDINE
- METHADONE
- PROPOXYPHENE
4. Influenza for Current Flu Season: Flu shot is ONLY good for the season which is 11/1 through 4/30.
If they start on May 1st, they don't need the vaccine until next Fall. It is recommended for Workers to wait and get the vaccine AFTER Sept 1st. The facility accepts a signed personal/medical exemption.
5. COVID Vaccinations
Fully vaccinated with Covid-24-25 Vaccine. The facility accepts a signed religious/medical exemption.
*Exemption form accepted for:
COVID
FLU
***Qualified Applicants with arrest or Conviction records will be considered for Employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act
| No | ||
|---|---|---|---|
| Onshore Only | ||
| No |
| Hours per Day | 8 |
|---|---|
| Hours per Week | 40 |
| Total Hours | 680.00 |
Attachment -
JOB DESCRIPTION
| Employee Name: | Position Title: Transplant Financial Coordinator | Job Code: C4345 | ||
| Department Name: Transplant | Cost Center: 1726-7036, 7028, 7032, 7033, | |||
| Description Creation Date: November 2021 | Revised Date(s): | HR Review and Approval: Name: | Non- Exempt | |
| I. Statement of Purpose |
| Under the direction of the TFC supervisor, the transplant financial coordinator (TFC) is a designated member of the multidisciplinary transplant team. His/her primary function is to assure transplant patients' medical services are covered by insurance. This includes: insurance verification, authorization submission, effective patient counseling of insurance plans, providing insurance guidance when patients have a lapse of insurance or are under-insured and solid understanding of the complexity of transplant benefits as dictated by different insurance coverage. S/he is responsible for accelerating patient financial clearance by following standardized process steps. The TFC is also expected to problem-solve in real time and provide appropriate insurance direction to patients and staff, as needed. The TFC will participate in team meetings and discussions related to complex cases, advancing operational throughput and process improvement to benefit patient care. S/he should possess analytic skills and be able to evaluate/analyze insurance information to effectively convey and communicate to others. S/he should have excellent verbal and written skills and an ability to easily learn hospital and transplant IT systems as they relate to financial clearance and insurance. Bilingual fluency is strongly preferred. |
| II. Reports To | III. Supervises (Department / Titles/Job Codes / Descriptions) |
| TFC Supervisor, Abdominal | n/a |
| IV. Job Qualifications | |
| Minimum Education: | HSD or GED AA required, BA/BS preferred (2 years transplant financial experience may substitute for minimum education) |
| Minimum Experience/Knowledge: | Experience in the medical field, including transplant and transplant finance preferred. Content knowledge of medical terminology and transplant process preferred. Ability to become proficient in EMR and various IT systems required. Demonstrated ability to problem-solve and provide effective resolution. Bilingual strongly preferred; if bilingual certified department translator strongly preferred. |
| Required License/Certification: | Fire and Safety Certification. If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only) |
| Job Summary: Position Accountabilities= 100% |
| Responsible for coordinating and clarifying patient-specific insurance and financial aspects of care with less than 5% inaccuracy. 5% Essential |
| Work with patients and their families from referral through post-transplantation in a compassionate and tactful manner, in order to help facilitate access to, and provide, continuity of care. Assist patients with questions concerning insurance and other financial issues. Work with other members of the transplant team, administrative staff, billing, financial and clinical personnel at KMC to ensure financial coverage of transplant and living donor services. Alert staff to issues impacting a patient's ability to undergo transplantation. 20% Essential |
| Obtain and document detailed patient insurance benefit information, limitations and exclusions to determine appropriateness for transplantation services and financial criteria of program, including, but not limited to, all aspects of the transplant process: transplant surgery, organ acquisition, follow-up clinic visits, admissions, cost of labs, diagnostic testing, co-payments of outpatient prescription drugs and travel/housing benefits. Discuss benefits, and other transplant financial issues, with patients and/or family members during initial evaluation, including each time a patient's insurance coverage changes. 5% Essential |
| Serve as a resource for patients and their family members on financial and insurance matters. Provide patients with educational materials, which cover transplant financial benefits and pitfalls, coverage options and insurance types. 5% Essential |
| Obtain all necessary payor authorizations, approvals and clearance. Verify transplant coverage and other medical benefits. Acquire necessary referrals/authorizations for planned admission and procedures with less than 5% inaccuracy. Assist, as needed, with financial clearance of urgent inpatient transfers and patients in need of clearance for critical or acute care. 20% Essential |
| Routinely monitor insurance coverage for patients throughout all phases of transplant, particularly while patients are waitlisted for an organ. Cultivate relationships with insurance case managers and medical directors to facilitate and expedite authorization approvals. Retrieve clinical data in a timely manner when requested/required by third party payers. 10% Essential |
| Identify and effectively communicate financial information to transplant team members, patients and their families with emphasis on identifying any potential patient out-of-pocket liability, clearance issues, coverage gaps and alternate funding options. Proactively guide patients through application processes for government funded/financial assistance programs (i.e. Medi-Cal, KMC charity program, QMB, Legal Aid, LIS, etc.) and coordination of benefits as necessary. 5% Essential |
| Facilitate resolution of patient billing issues. Serve as a liaison to USC Care and Keck billing offices to resolve billing questions and problems. 3% Marginal |
| Maintain familiarity with UNOS and CMS regulations related to transplant finance and billing practices. Follows KMC and transplant institute policies and procedures. Apply financial guidelines, protocols and policies equally when engaging patients, families and payors. 2% Marginal |
| Work with clinical staff to coordinate recipient and living donor benefits, financial clearance, authorizations, planned surgical events and clarify any insurance issues related to living donation. 5% Essential |
| Participate in the weekly transplant selection committee meetings and multidisciplinary clinics to provide financial insurance expertise specific to individual patients and candidates. Prepare financial reports for each patient prior to the clinic or selection committee to best facilitate decision-making for patients and the multidisciplinary team. 5% Essential |
| Engage non-contracted health plans and medical groups to interface with Keck Hospital and USC Care contracting departments to obtain LOA, or other financial guarantees, to effectively cover transplant services from a fiduciary standpoint. 2% Marginal |
| Follow all HIPAA related compliance by keeping patient clinical/personal information private. This includes, but is not limited to: Confirming a minimum of two patient identifiers prior to discussions with patients and staff, sending written or electronic communications and/or entering new information into electronic systems. Prior to speaking with any patient representatives confirm the representative is noted in the EMR, or transplant EMR, to receive HIPAA related information. If a HIPAA violation occurs, communicate immediately with a supervisor, quality department representative and enter the violation into the risk management system. 3% Essential |
| Act as a business professional in interaction and appearance by providing superior customer service when interfacing with patients, peers, physicians, superiors and hospital personnel/leadership. Represent the transplant department in a positive and proactive way to others when discussing role and duties. 5% Essential |
| Establish a sense of comradery among peers and with supervisor/lead TFCs to facilitate teamwork with others and throughout the department. Work well with others to problem-solve, provide coverage when necessary and assist clinical and non-clinical staff during acute and unforeseen circumstances to advance patient care. 5% Essential |
| Perform other duties as assigned. |
NOTE: Accountabilities % must add up to 100% and complete page 5-6
| VI. Physical Demands: C= Constant (6-8 hours/day ) F= Frequent (3-6 hours/day) O= Occasional (1-3 hours/day) I = Infrequently (0-1 hours/day) | |||||||||
| Sit | C | Crawl | I | Repetitive Motion | C | Reaching (above shoulder level) | C | ||
| Stand | F | Bend/Stoop | O | Simple Grasping: right, left or both hands | C | Reaching (below shoulder level) | C | ||
| Walk | F | Kneel/Squat | O | Power Grasping: right, left or both hands | O | Twist: neck, waist | F | ||
| Climb | I | See | C | Fine Manipulation: right, left or both hands | C | Other (Specify): | |||
| Hear | C | Speak | C | Keyboard, Mouse | C | ||||
| Balance | C | Pull | C | Feel: perceiving attributes of objects, such as size, shape, temperature by touching of skin, particularly that of fingertips. | I | ||||
| VII. Visual Acuity Requirements including color, depth perception, and field vision. Place an "X in the visual acuity requirement description that best describes the position. | |||||||||
A | The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading reaching visual inspection involving small defects, small parts, and/or operation of machines (including inspection); using measurement devices; and/or assembly or fabrication parts at distances close to the eyes. | ||||||||
| B | The worker is required to have close visual acuity to operate motor vehicles and/or heavy equipment. | ||||||||
| C | The worker is required to have close visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned (i.e., custodial, food services, general laborer, etc.) or to make general observations of facilities or structures (i.e., security guard, inspection, etc.) | ||||||||
| VIII. Unassisted LIGHT MODERATE HEAVY | |||||||||
| Lift | 0 24 lbs 25 - 50 lbs 51+ Lbs | ||||||||
| Push | 0 24 lbs 25 - 50 lbs 51+ Lbs | ||||||||
| Carry | 0 24 lbs 25 - 50 lbs 51+ Lbs | ||||||||
| IX. Environmental Conditions If over 20% of work is exposed to condition, place an 'X' in the space provided | |||||||||
| Confined Space | X | Outdoor exposure | Potentially hazardous materials/conditions | X | Potential Allergens/Irritants | X | |||
| Noise Exposure | Extreme Temperatures: Hot/Cold | Vibrations | Other (Specify) | ||||||
X. Age Specific Patient Populations Served | Young Children: 2 to<4 years Older children: 4 to<14 years Adolescent: 14 to<18 years Young Adult: 18 to<40 Middle Adult: 40 - <65 years Older adult: 65 to<75 years Geriatric: > 75 years No direct patient contact under normal circumstances | ||||||||
XI. Specialized Patient Populations Served | Bariatric Cystic Fibrosis No direct patient contact under normal circumstances Transplant Orthopedic Surgical patients Dialysis Other: Various patient population served based on disease type. | ||||||||
| XII. Blood-borne Pathogen Exposure Category | |
| Category I | Job usually involves contact with patients or patient specimens. Exposure to blood, body fluids, non-intact skin or tissue specimens, is possible. |
| Category II | Job may expose employee occasionally or in emergency situations to blood, body fluids, non-intact skin or tissue specimens. |
| Category III | Job does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Employee does not perform or help in Emergency medical care or first aid as a part of his/her job. |
| XIII. Access to Protected Health Information | |
Check all applicable types of protected health information that this position requires access to: | No access to patient protected health information Access to general patient information (e.g. census lists, room lists) Access to patient clinical information and records (e.g. medical records) Access to patient financial information and records (e.g. billing records) Access to administrative information and records containing patient information (e.g. reports, QA documents, audits) Other: |
Check all applicable uses for protected health information that pertain to this position: | No access is required. Treatment (need to access to provide direct clinical care) Payment (need access to register, charge, bill and/or collect for services rendered to patients) Operations (need access to perform duties in support of patient care and to maintain/administrate the hospital) Other: |
The above statements reflect the essential and non essential functions considered necessary to describe the principle contents of the job. They are not intended to be a complete statement of all work requirements or duties that may be inherent in the job.
I acknowledge receipt of a copy of this position document. I have read this job description and agree to abide by its contents. I realize the duties may be requested of me that are not specifically stated herein. I agree to perform these duties as directed by my supervisor. I understand that I will be expected to adjust to potential fluctuation in work volume. I understand that, if I have any questions about the essential functions or expectations of my position, my supervisor is available to discuss them with me.
Print Employee Name Signature Date
Source : Abacus Service Corporation
