Christiana Care is seeking a full time Financial Coordinator for their Weight Management Department.

The Weight Management Financial Coordinator, is an advocate on behalf of patients and families and is responsible for obtaining detailed patient insurance benefit and related financial information for all aspects of the bariatric preparation and surgical process, including but not limited to, the evaluation, bariatric surgery preparation process to include both the Nutrition visit and the Psychology visit, in-patient bariatric surgery, and follow-up outpatient visits (Bariatric Nurse Practitioner and Registered Dietitian visit). 

The Weight Management Financial Coordinator together with other appropriate interdisciplinary team members is also responsible for ensuring appropriate authorizations are obtained and documentation is prepared to allow for appropriate billing for all charges.

This position is in Wilmington and eventually will be located in Elkton, MD as growth continues within this department

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Functions as the primary resource for patients that have questions related to insurance coverage and related financial matters for the bariatric program.
• Advocates for patients and family members and acts as a liaison with insurance companies to assist in obtaining insurance information.
• Identifies and facilitates the submission of required documentation or surgical clearance and obtains any insurance authorizations and approvals.
• Researches and documents all insurance plans and confirm patients benefit eligibility, including patient surgical pathway class requirements.  Tracks and reports any insurance requirement changes to the bariatric team.
• Resolves any discrepancies by contacting patients as required.
• Assists and advises patients and family members in locating resources and/or assistance programs for which uninsured/underinsured patients may be eligible.
• Provides information to the appropriate billing specialist to ensure accurate billing for current and future services.
• Reviews and interprets insurance group pre-certification requirements.  Ensures proper pre-authorizations have been obtained.  Completes any necessary on-line operations for specific payors to complete the pre-certification process.  As necessary communicates data to utilization management to continue medical review process.
• Coordinates the ongoing pre-certification and approval process with insurance case managers and assist case managers with discharge planning in order to coordinate the most appropriate level of care for patients.
• Obtains referral from patients Primary Care Physician prior to admission for managed care plans when applicable.
• Handles all bariatric (including the dietitian visit and psychology clearance visit) related insurance questions and when necessary obtains information from various sources including but not limited to clinics, physicians, patients, payors and other outside agencies.
• Maintains up to date records on a daily, weekly and monthly basis of all accounts pending verification reviews, utilizing transplant database lists and take appropriate action to resolve accounts. 
• Maintains accurate departmental statistical data as required by local, state and federal regulatory agencies.
• Represents CCHS to external agencies on issues involving financial policies and procedures.
• Completes notification and evaluation results form for commercial on-line systems in a timely manner to assure payment.
• Facilitates resolution of patient billing issues related to bariatric preparation visits and surgery.
• Communicates any insurance needs that effect patients surgical dates in a timely manner to the Weight Management and Bariatric Care Team.
• Performs assigned work safely, adhering to established departmental safety rules and practices.  Reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
• Performs other related duties as required.

EDUCATION AND EXPERIENCE REQUIREMENTS:

• Minimum of a high school diploma or equivalent. 
• Associate degree in business or healthcare field with course work in accounting, business and/or health care administration preferred. 
• Extensive knowledge and comprehension of insurance standards and regulations required. 
• Managed care experience and related experience with third party payor processes related to inpatient, outpatient and physician billing and specialized documentation requirements relating to transplant coverage a plus.

KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:

• Knowledge of current managed care requirements.
• Knowledge of current self-funded payor plans and requirements.
• Knowledge of current billing documentation requirements.
• Knowledge of current community resources, state and federal programs.
• Skill using computers including working knowledge of MS Word, Excel and Access.
• Ability to maintain confidentiality.
• Ability to organize and prioritize work assignments.
• Ability to maintain flexibility and program stability while working in a high volume and deadline driven environment.
• Ability to review, analyze and act upon third party benefit discrepancies prior to billing.
• Ability to function as a member of an interdisciplinary team.

EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.