The Senior Collections Rep (Transplant Financial
Counselor) performs all admission functions including in-house financial
management as well as provides leadership within his/her functional
area. Responsible for verifying accurate
demographic and financial information and knowledgeable in the review and
interpretation of insurance benefits, performs financial counseling,
financial screening, and credit assessment. Establishes all financial arrangements, refers appropriate cases to
other agencies, internal and external, to assist patients with discharge/post
hospital care. Interacts closely with
Utilization Review and Patient Business Services to ensure correct and timely
Under the general direction of the Transplant Financial
Manager and Director of Transplant Services, but will independently prioritize
and complete standard functions following established departmental guidelines
and University policies. Work is
reviewed by the Transplant Financial Manager on a consistent basis and when
deviation from standard guidelines occurs.
- Working knowledge of third party payer verification terminology
- Working knowledge in the functional operations of third party payors and utilization review agencies to expeditiously coordinate follow-up
- Working knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
- Working knowledge of health plans with special processing requirements for emergency patients and ability to effectively communicate these requirements to physicians and administrative personnel under time urgent conditions.
- Ability to scrutinize credit reports and evaluate personal financial information to detect any problems, discrepancies or questionable areas and set up an appropriate financial arrangement when necessary (May be trained)
- Ability to attend to many details within a short span of time
- Knowledge of the availability of specific accommodations for patients on various nursing units to initiate proper room and care charges (May be trained)
- Skill in detecting erroneous data input that would otherwise disable census system output mechanism
- Knowledge of physician team and specialty to accurately validate medical services rendered to patients (May be trained)
- Knowledge of unit specialties with specific regards to proper patient and team assignment (May be trained)
- Ability to monitor bed availability, predict, and communicate possible problems to appropriate departments (May be trained)
- Working knowledge of HMO’s and PPO’s, in order to understand, explain and calculate Per Diem rates, contractual allowances and percentage discounts.
- Skill in computing rations, rates and percentages in order to calculate estimated pro-rated balances and patient liability.
- Skill in analyzing information, problems, situations, practices or procedures in order to define the problem/objective; identify relevant concerns/factors; identify patterns, tendencies or relationships,; formulate logical and objective conclusions; recognize alternatives and their implications
- Working knowledge of the department functions of an acute care hospital and their organizational interrelationships
UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.