Global Transplant Specialist II

Scope of Position

The Global Transplant team functions as an integral part of the Revenue Cycle. Each member serves as a financial contract case coordinator, ensuring our transplant claims are submitting timely and effectively, submitting the professional claims for various physician groups, following up with the various transplant payer agencies, and collaborating with the financial counselor and authorization teams. The global transplant representative must know unique contract details for each of our global agreements, which vary by facility and by transplant type. The position is expected to perform at a higher level taking on the combined responsibilities of hospital billing, professional billing, case reconciliation, accounts receivable, contractual understanding, and credit balance resolution.

Position Summary

The Global Transplant representative facilitates the collection and submission of all global transplant claims, in accordance with our various transplant contracts. This requires knowledge and understanding of all the organ transplant types, how they interact with our payer contracts, implications of varying transplant phases, case rates, stop loss, and reconciliation. This starts at the beginning with the set up of our global cases in our EMR, notifying our physician group partners, communicating with partners in financial counseling, authorization, monitoring the progress and maturity of the patients transplant, and prompt and accurate payment by the payer. The global transplant representative will also monitor and escalate accounts for underpayment, handle denied cases by routing to appropriate teams, and ultimately, guaranteeing any patient owed balances are correct.

Minimum qualifications

High School Diploma or GED. PC knowledge and interpersonal, verbal and written communication. Minimum 6 months experience in customer service or a healthcare environment. Bachelors Degree preferred or equivalent combination of education and experience in healthcare or physician practice preferred. Medical terminology, ICD-9 diagnosis coding and third party reimbursement experience a plus. Demonstrated ability to work in multiple Databases for management and reporting. Ability to work in self-directed manner while interacting with consumers, physicians and all medical center faculty and staff. Familiarity with OSUMC and its entities preferred. Qualified candidates may be asked to complete a pre-employment physical including a drug screen and background check.

Preferred Qualifications: Two years experience in patient accounting, either in billing, follow up, denials, or similar