This position is responsible for supervising the day to day operations for all transplant financial operations to include Transplant Financial Coordinators, Technicians and Transplant Revenue Cycle staff (Billing Reimbursement Specialists). Position is responsible for managing all transplant-related patient accounts and transplant revenue from pre-registration through billing and collections, hospital and vendors including account payable management. Acts as an oversight resource by providing an understanding of a transplant candidates insurance benefits and financial means and assists with attempt to procure alternative sources of payment. Also acts as a resource to ensure the oversight of maximum allowable reimbursement from all sources is received for transplant. Position will work with outside vendors to ensure that we receive the third party vendor claims in a timely manner.

1. Supervises the daily operational activities, financial staff and communications within department.
   • Provides supervision to staff and ensures work flow processes are consistent within all applicable regulations and established policies, procedural guidelines and best practices for Transplant Revenue Cycle operations, including financial counseling and for transplant patient families. Provides back-up for key functions that must be accomplished in the absence of staff.
2. Obtains and evaluates patient financial status.
   • Verifies and updates demographic and financial information in appropriate systems to ensure timely billing. Ensures that the Transplant AR is classifies correctly, meaning that there is no medical management claims held as Transplant AR within the HRC and /or PRC Accounts receivable.
3. Secures the maximum allowable revenue generation for solid organ and bone marrow transplant and related services through timely and appropriate service authorization, billing and collection.
   • Establishes, implements and evaluates systems to monitor accuracy and timeliness of data entry and claims submission to appropriate payers for transplant episodes of care and related services. Audits charges and payments to ensure reimbursement reconciled to expected revenue.
4. Maintains current and thorough knowledge of online system tools to utilize when required.
   • Works from manual reports when system report are not available. Identifies liable parties/insurance carriers by appropriate financial class and health plan.
5. Assists with A/P processes for transplant patients to ensure services provided by non-PCH providers that fall within the global payment period are reimbursed timely and provides exemplary customer service to these providers. Also establishes and maintains good vendor relationship for purchased services.
6. Prepare and distributes a variety of standard reports to provide feedback to management. Assists with report production to monitor A/R, A/P and team assignments.
   • Trains new employees on the work flow of the transplant team and the operations in the revenue cycle.
7. Acts as a resource for payers, employees and management by researching, resolving and helping clear transplant claim discrepancies.
8. Review and interpret transplant contracts for billing guidelines and contracted reimbursement amounts.
   • Approve refunds and adjustment as they relate to transplant accounts and coordinates with management for approval of accounts that are above their threshold. Conducts QAs on employees to ensure accuracy and quality.
9. Performs miscellaneous job related duties as requested.

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

• Offering the most comprehensive care across ages, communities and specialties
• Investing in innovative research, including emerging treatments, tools and technologies
• Advancing education and training to shape the next generation of clinical leaders
• Advocating for the health and well-being of children and families

Values

• We place children and families at the center of all we do
• We deliver exceptional care, every day and in every way
• We collaborate with colleagues, partners and communities to amplify our impact
• We set the standards of pediatric healthcare today, and innovate for the future
• We are accountable for making the highest quality care accessible and affordable