Navigator Transplant Benefits


OU Medical System


Posted Under: Oklahoma City, Oklahoma jobs in Other; Other jobs in zipcode 73101
Posted On: 2019-10-11 00:00:00

JOB DESCRIPTION:

GENERAL DESCRIPTION:

Under general supervision, interviews patients referred to the Transplant Center and determines financial suitability of the patient for transplant. Monitors expenses incurred by the Transplant Center to ensure all charges to organ acquisition are appropriate. Monitors Transplant Center patient registration throughout OUMS to prevent inappropriate charges to the organ acquisition account. Predicts post transplant benefit coverage and out of pocket expenses. Provide guidance to patients in navigating public benefit offerings to ensure appropriate and best insurance coverage.

ESSENTIAL RESPONSIBILITIES:

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.

* Financial assessment as it pertains to benefit coverage of pre/peri/post organ transplant services.

* Annually update and verify coverage of OUMS patients on the national wait list.

* Assist transplant team in directing them to appropriate source for post transplant medication ordering/dispensing.

* Assist non documented US residents referred for transplant through immigration process to obtain legal residency status.

* Investigate issues with benefit providers and escalate the issue if needed to obtain benefits for our patients.

* Maintain detailed record of all communication, both written and spoken with 3rd party payers.

* Develop negotiate one time agreements with payer sources for transplant services on behalf of the hospital.

* Provide life coach counseling to patients relative to benefits, medications, ACA, Social Security and Disability

GENERAL RESPONSIBILITIES:

* Conduct financial assessment of each patient referred for transplant to determine their benefits and out of pocket medical expenses post transplant

* Serve as liaison to 501 (3) (c) group for patients who need financial grants.

* Assist patient in investigating other sources of income or potential ways to decrease expenses in order to meet criteria for transplant.

* Develop good working knowledge of available legal, benefits, and financial services to assist the transplant population

* Participate in the transplant multidisciplinary team to determine if a patient meets transplant criteria established by OUMS.

* Attend and engage in Transplant Patient Selection Committee mmetings.

* Performs other duties as assigned

MINIMUM QUALIFICATIONS:

EDUCATION: None

EXPERIENCE: Five years of hospital or medical experience in transplant or related healthcare field which includes experience in admitting, financial counseling, insurance verification or related area.

OR

An equivalent combination of education and experience.

LICENSURE/CERTIFICATIONS/REGISTRATIONS REQUIRED: None

KNOWLEDGE, SKILLS AND ABILITIES: Knowledge of hospital policies and procedures. Excellent customer service skills. Knowledge of third party contractual agreements and requirements. Knowledge of applicable federal and state laws and regulations. Skill in establishing and maintaining effective working relationships with others. Ability to follow verbal and written instructions. Ability to effectively interview patients and obtain necessary information. Ability to work effectively with insurance companies. Good typing skills. Excellent communication skills, both verbally and in writing. Good computer skills. Ability to operate standard office equipment such as copy machine, telephone and fax machine.

Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, gender, national origin, age, disability, sexual orientation, gender identity, genetic information or protected veteran status in accordance with applicable federal laws. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, transfer, leaves of absence, compensation, and training. Reasonable accommodations are made to the known physical and mental limitations of qualified individuals with disabilities.