Navigator Transplant Benefits

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Location: OU Health Transplant Institute

Shift Available: Full-time (40 Hours/Weekly) Days

OU Health Transplant Institute is located at 920 NE 13th St, Oklahoma City, OK 73104. This facility provides both kidney and liver transplant procedures and care. This facility analyzes the full picture of everything that is needed to work to provide a healthy outcome.

Under general supervision, reviews insurance benefits and contacts patients referred to the Transplant and Cellular Therapy (TCT) Program and to help determine financial suitability of the patient for transplant. Monitors TCT patient registration to help prevent inappropriate charges to the TCT account.

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 transplant and cellular therapy services.

* Annually update and verify coverage of OU Health patients in the TCT program

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

* Assist non-documented US residents referred to TCT program

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

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

* Assist with 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.

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

* Collaborate with Social Work colleagues as liaison to 501 (3) (c) group for patients who need financial grants.

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

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

* Attend and engage in TCT Patient Selection Committee meetings.

* Opening TCT cases, and obtaining appropriate authorizations.

* Performs other duties as assigned.

Minimum Qualifications:

Education: High School Diploma or GED required.

Experience: 0-3 years of experience required. 4 of more years of experience in transplant or related healthcare field with experience in admitting, financial counseling, and insurance verification preferred.

Licensure/Certifications/Registrations Required: None required.

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 computer and typing skills.
• Excellent communication skills, both verbally and in writing.
• Ability to operate standard office equipment such as copy machine, telephone, and fax machine.