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Financial Case Manager

Financial Case Manager

University of California - San Francisco Campus and HealthSan Francisco, CA, United States
2 days ago
Job type
  • Full-time
Job description

Admissions and Registrations

Full Time

86911BR

Job Summary

The Bone Marrow Transplant (BMT) Financial Case Manager is a critical member of the Bone Marrow Transplant multidisciplinary team(s) and works collaboratively with physicians, nurse coordinators, social workers, practice coordinators, and external insurance case managers to ensure that patients are financially eligible and cleared for services throughout the transplant process. The Financial Case Manager incorporates knowledge of BMT‑specific emerging therapies, such as CAR‑T, and ensures appropriate payor rules are followed. Collab‑orates with the Contracting Department for non‑contracted payors and resolves billing issues for transplant‑related services with UCSF's billing representatives. Manages a large caseload that involves counseling and education during the evaluation, waitlist, and transplant phases of care. This is a critical role and is required of all transplant programs as stated in the United Network for Organ Sharing (UNOS) bylaws.

Works independently and follows the guidelines as set forth by the transplant and Patient Access Services department policies and procedures. Provides patient education on insurance rules and regulations, counseling on transplant‑specific financial expectations, reviewing patient financial responsibility, coordinating the insurance process for patients for evaluation, waitlist testing, living donor workup, Autologous or Allogeneic Donor Transplant Surgery, and other specialty referral appointments as necessary. This includes obtaining all needed authorizations for above mentioned services while seeking to maximize the utilization of benefits and coordinate cost‑effective care in a managed care environment for each patient.

Your placement within the salary range is dependent on a number of factors, including your work experience and internal equity within this position classification at UCSF. The salary range for this position is $72,000–$154,000. To learn more about the benefits of working at UCSF, including total compensation, please visit : https : / / ucnet.universityofcalifornia.edu / compensation-and-benefits / index.html

Required Qualifications

  • Bachelor's degree in a related area or four years of relevant experience and three (3) years of experience with insurance benefits and authorizations.
  • Advanced interpersonal skills to develop productive ongoing relationships with payors, outside agencies, and patients. Ability to interact with patients about financial preparedness, insurers, and other parties.
  • Strong computer proficiency in all relevant applications and software, with a knowledge of spreadsheet and document applications, and a variety of specialized billing and insurance systems.

Preferred Qualifications

  • Thorough knowledge of insurance processes, concepts, systems, and external regulations.
  • Knowledge of medical terminology, coding, and billing.
  • Strong analytical skills, attention to detail, conducting interviews and research, developing and recommending new systems, workflows, and procedures.
  • Ability to serve as a technical leader, providing expertise and serving as an educational resource to staff and management at all levels.
  • Experience working in organ transplantation.
  • Transplant Financial Coordinator Certification.
  • License / Certification

    Preferred : Transplant Financial Coordinator Certification.

    About UCSF

    At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.

    Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.

    Pride Values

    UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

    In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu.

    Join us to find a rewarding career contributing to improving healthcare worldwide.

    Equal Opportunity Statement

    The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

    Organization

    Health

    Job Code and Payroll Title

    004542 PAT BILL AND COLL REPR 4

    Job Category

    99 - Policy-Covered (No Bargaining Unit)

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