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The Transplant Financial Coordinator (TFC) is a critical member of the multidisciplinary transplant team, working under the direction of the TFC Supervisor. This role is focused on ensuring that transplant patients’ medical services are covered by insurance. Responsibilities include insurance verification, authorization submission, patient counseling on insurance plans, and providing guidance for under-insured patients or those experiencing lapses in coverage. The TFC plays a vital role in accelerating financial clearance by following standardized procedures and actively contributing to process improvement initiatives to enhance patient care.  

• Verify insurance coverage and submit authorizations for medical services.  

• Provide clear and effective patient counseling on insurance benefits, coverage gaps, and options.  

• Understand and communicate transplant-specific benefits for various insurance plans.  

• Solve real-time issues by offering quick, accurate insurance guidance to patients and staff.  

• Collaborate with multidisciplinary teams in case discussions and contribute to team meetings.  

• Follow standardized steps to ensure timely patient financial clearance.  

• Analyze insurance information and communicate findings effectively to relevant stakeholders.  

• Learn and utilize hospital and transplant-specific IT systems to support financial clearance processes.  

• Participate in discussions on complex cases to improve operational throughput.  

• Professional appearance.  

• Strong knowledge of insurance coverage, including Commercial, Medicare, Medi-Cal, HMO, and PPO.  

• Proven experience in insurance verification and authorization processes.  

• Ability to explain insurance benefits and options to patients clearly and effectively.  

• Solid understanding of transplant-specific insurance coverage.  

• Strong real-time problem-solving skills to address patient and staff needs.  

• Analytical skills for evaluating insurance data and communicating findings.  

• Excellent verbal and written communication skills to convey complex information.  

• Team collaboration skills with the ability to contribute to case discussions.  

• Process-oriented with a commitment to improving workflows and operational efficiency.  

• Tech-savvy, with the ability to learn and use hospital and transplant IT systems efficiently.  

• Experience with Epic, Cerner, or OTTR systems (preferred but not required).  

• Familiarity with Passport Eligibility Verification System (preferred but not required).  

• Bilingual fluency to enhance communication with diverse patient populations (strongly preferred).  

• Experience working in transplant programs or hospital settings.  

• Familiarity with complex insurance cases and financial clearance workflows.  

• Involvement in process improvement initiatives to enhance patient care or workflow efficiency.