Job Description

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better?

The Transplant Financial Liaison reflects the mission, vision, and values of Northwestern Memorial, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

This position ensures continuity of admitting, registration, billing, collections, and other services through expertise in and across specific disciplines for third party payers, contracted vendors, and designated hospital programs.

Responsibilities:

• Interviews potential Kidney and Liver Transplant candidates: gathers pertinent demographic and insurance information.
• Reviews all new kidney patient files for benefit exclusions and limitations.
• Monitors all information being sent to patients and insurance companies.
• Reviews and corrects all new liver registrations.
• Verifies transplant insurance benefits for primary and Secondary carriers for Kidney and Liver Transplant candidates.
• Identifies transplant benefits for both the hospital and professional components related to the transplant services, potential limitations and pre-certification requirements.
• Evaluates expected reimbursement to minimize financial risk of the programs including evaluating and communicating with patients potential financial responsibilities.
• Weekly registration for all new Liver candidates.
• Follow up calls for all pending Kidney transplant cases.
• Performs pre-certification as required for evaluation, transplant and post-transplant services.
• Performs pre-certification of all Access and Elective surgeries.
• Consults with patient's donors regarding transplant coverage.
• Discuss with donor the necessity of all bills coming to the transplant facility.
• Collaborates with the billing team concerning any patient or insurance issues.
• Collaborates with payer Case Managers concerning potential transplant patients listed or not listed and update of clinical status.
• Collaborates with Managed Care in developing and obtaining single case rate letters for foreign nationals as well as all self-pay patients.
• Reviews NMFF patient information forms and files copies in pre-liver patient files.
• Coordinates with the Medical Center pharmacy the take home medications for patients who are either donors or have a single case agreement.
• Reviews and monitors all CMH donor patient accounts.
• Participates in Kidney Educational meetings.
• Participates in Kidney and Kidney, Pancreas and Liver multi-disciplinary meetings.
• Performs yearly transplant insurance audit mail out.
• Mails out or faxes all clinical information to payers.
• Supplies all insurance information to NMFF for billing.
• Reviews Consent forms and checks for current status including signature, date, and timeliness.
• Reports on activities, issues, and any action items to management and staff.
• Ensures responses to patient and customer inquiries, providing feedback to suppliers and providing assistance to others performed completely, accurately, and within the time frames defined within division standards, objectives, and goals.
• Completes other duties as assigned by director or manager.
• Meets or exceeds departmental, divisional, and institutional goals.
• Adheres to NMH, divisional and departmental quality standards.
• Identifies opportunities for and participates in process improvement activities.

Qualifications

Required:

• Experience in Revenue Cycle or Patient Access.
• Associate Degree or equivalent work experience.

Preferred:

• Experience in Epic HB and PB Billing.
• Experience in Transplant Billing or Transplant Clinical applications
• Understanding of Transplant contracts.

Additional Information

Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Background Check

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act.

Artificial Intelligence Disclosure

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.

Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.