Five (5) Positions Available

Employees at this level are professionals who assist in the preparation, maintenance, and monitoring of a health care facility’s third party reimbursement reporting. They also perform routine costing and analysis of data for submission to outside facilities agencies. They work under the general supervision of the transplant administrator. The position also includes acting as a financial resource on transplant financial issues to hospital departments and physician consultants.

Completes financial modeling to ensure all possible reimbursement enhancement opportunities are captured.

Gathers data and completed required analysis at the request of outside audit staff during audits by Medicare, Medicaid, Private insurers and reports impact of the audit adjustments to management.

Assists management in the analysis and development of pricing models for private insurer contracts.

Assists management in the budgeting and forecasti ng of program revenues.

Recommends improvements and modifications to departmental operating procedures to maximize operating efficiency and reimbursement.

Counsels patients on options for coverage of transplant immunosuppressive medications.

Advises underinsured patients to take corrective actions to enhance their insurance coverage.

Collaborates with other departments to provide documentation necessary for optimizing reimbursement on transplant cases.

Obtain financial clearance for patients' evaluation, transplant, and postoperative immunosuppressive therapy.

Act as financial liaison between the transplant program and the patients served by it.

Collaborate with other professional staff members within and outside the transplant team to meet the individual needs of the program

Prepare and maintain necessary records and reports related reimbursements for transplant cases

Perform charge entry and other database entry as directed

Performs other related duties as assigned.

CREDENTIALS TO BE VERIFIED BY PLACEMENT OFFICER

 

1. Any one or any combination of the following types of preparation:
   1. credit for college course work comparable to that leading to a major in accounting, business administration, or finance
   2. progressively more responsible work experience and/or on-the-job training that provided a knowledge of generally accepted principles, theories, and practices used in one of the above fields and that was of such scope, level, and quality as to assure the applicant’s ability to undertake entry level professional work in one of the above fields; such work experience and/or on-the-job training must be evaluated on the basis of their/its comparability to a normal curriculum in one of the above academic programs, taking into account the relationship of the work experience and/or on-thejob training to the content of the courses in the curriculum.

      that totals 1.0 unit according to the following conversion rates:

      • 120 semester hours (or Bachelor’s degree) of "A" = 1.0 unit
      • 3 years of "B" = 1.0 unit.
       

      Amounts of training or experience less than those listed above should be converted to decimal equivalents of 1.0 unit and added together when computing combinations of the different types of preparation.

      NOTE: Possession of a Certified Public Accountant certificate satisfies requirement 1.

2. one year of professional experience in third-party reimbursement for health care facilities (such as an accountant or auditor)