We are hiring for our client in the higher education and healthcare industry.
Duration: 3 months (extendable)
Shift Timings: 8:30 am to 5 pm
Responsibilities:
- Verify insurance coverage and submit authorizations for transplant-related medical services.
- Counsel patients on insurance plans, benefits, coverage gaps, and available options.
- Provide real-time insurance guidance to patients and staff.
- Ensure smooth financial clearance by following standardized workflows.
- Participate in multidisciplinary team meetings and case discussions.
- Contribute to process improvements to enhance operational efficiency.
Must-Have Qualifications:
- Insurance Knowledge - Familiarity with Commercial, Medicare, Medi-Cal, HMO, and PPO plans.
- Insurance Verification & Authorization - Experience verifying coverage and obtaining approvals.
- Patient Counseling - Ability to explain insurance benefits and financial responsibilities to patients.
- Transplant-Specific Knowledge - Understanding of transplant-related insurance policies.
- Problem-Solving Skills - Capable of addressing complex insurance issues in real time.
- Analytical Skills - Ability to interpret insurance information and communicate findings.
- Communication Skills - Strong verbal and written skills for patient and team interactions.
- Team Collaboration - Willingness to work with multidisciplinary teams.
- Process-Oriented - Follows established workflows for financial clearance.
- Tech Savvy - Ability to quickly learn hospital and transplant-related IT systems.
Nice-to-Have Qualifications:
- Healthcare IT Experience - Knowledge of Epic, Cerner, OTTR, or Passport Eligibility Verification System.
- Bilingual Fluency - Strong preference for Spanish or other commonly spoken languages.
- Hospital/Transplant Experience - Prior experience in a transplant program or hospital setting.
- Complex Insurance Cases - Comfortable handling under-insured patients and coverage lapses.
- Financial Clearance Workflows - Familiarity with processes to accelerate approvals.
- Process Improvement - Experience contributing to workflow and patient care enhancements.