UW Medicine's mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow's physicians, scientists and other health professionals. UW Medicine owns or operates Harborview Medical Center, Northwest Hospital & Medical Center, Valley Medical Center, and UW Medical Center, a network of UW Medicine Neighborhood Clinics that provide primary care, UW Physicians, UW School of Medicine, Airlift Northwest, and other owned, operated or affiliated entities as appropriate. In addition, UW Medicine shares in the ownership and governance of Children's University Medical Group and Seattle Cancer Care Alliance a partnership among UW Medicine, Fred Hutchinson Cancer Research, and Seattle Children's. UW Medicine Financial Access Clearance Team Services Department (FACT): This position is located at the University of Washington Medical Center (UWMC) hospital campus.Under general supervision, The Financial Access Specialist 2 (FAS-2)for Transplant Specialty Services is responsible for interviewing potential transplant recipients to fully assess the patients' insurance coverage and obtain financial clearance to begin the transplant work up. The position serves as a liaison between the hospitals, patient and third party payers for all financial matters and secures necessary authorizations to ensure transplant related services are approved before proceeding with treatment. The Financial Coordinator educates patients regarding their insurance coverage, and advises them of any financial responsibility they may have. Active participation is required in department staff meetings, selection meetings and huddles. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:
Obtaining detailed patient insurance benefit information for all aspects of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and housing if necessary. Document patient's eligibility and benefits in Max and in Epic Transplant Guarantor account.
One-on-one interviewing over the phone and/or in person to interpret benefits and other transplant financial information with patients and/or family members during initial evaluation. Advising patients on insurance and billing issues and options. Serving as a resource for patients and their family members on financial matters.
Identifying and effectively communicating financial information to transplant team members,Patients and their families with emphasis on identifying any potential patient out-of-pocket liability.
Monitoring and updating information regarding insurance data, physicians, authorizations, and preferred providers.
Obtaining all necessary payer authorizations. Verifying transplant coverage and other medical benefits and acquiring necessary referrals and authorizations. When necessary request single case agreement with non-contracted health plans through UW Medicine Contracting Department.
Complete Inpatient admission notification for urgent or planned admissions. Coordinate with the Utilization Management department to facilitate patient admission/discharge information to fulfill insurance carrier requirements.
Communicate with appropriate clinical staff the status of ongoing payer requests and the need for additional information in order to facilitate completion of all payer requirements; Notify appropriate persons of denials and/or potential denials for non-covered services and other problems; initiate communication to appropriate agencies and to hospital staff for appeal of denials; Conduct necessary follow up on all initiated prior authorizations at pre-determined intervals in an effort to obtain the final authorization number i.e. insurance approval
Establishes and maintains a working relationship with key contacts at insurance companies (i.e. case managers, medical directors) and other departments in UWMC (i.e. Patient Financial Services, IECS (Insurance Eligibility & Counselling Services), Contracting .......etc) Attends and participates in transplant team meetings including Selection Meeting and; or huddles
Maintains current knowledge of Medicare and Medicaid rules or any legislation affecting the transplant patients. Continually networks with other FAS 2 in Transplant Specialty Services and Transplant Financial Coordinators, organizations, and centers to expand knowledge and understanding of the transplant process.Requirements: High School diploma or GED certificate plus two years of experience in a medical office setting; OR, equivalent education/experience.
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergraduate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.