Specialty Transplant Billing Operator
Core
Accurate, timely billing, accounts receivable follow-up, and denial resolution for complex transplant accounts in a large health system.
Role type
Specialty Transplant Billing Operator
Builds
Hospital (facility) billing operations for transplant services
Domain
Healthcare billing and reimbursement
Required skills
UB-04/837I claim preparation, Medicare/Medicaid/commercial payer rules, denial resolution, appeals management, organ acquisition cost billing, transplant phase billing, payer contract validation, Epic Resolute/Cerner/Meditech proficiency
Preferred skills
None stated
Technologies
Epic Resolute, Cerner, Meditech
Responsibilities
Prepare and submit hospital claims for transplant services; follow up on assigned A/R inventory with payers; research and resolve denials and underpayments; prepare and submit appeals; validate payer reimbursement against contract terms; verify authorizations and referrals; coordinate with clinical and coding teams; document account activity; escalate payer trends and process gaps; bill and reconcile organ acquisition costs; support Medicare cost report reconciliation; identify and correct transplant-specific billing errors; apply payer-specific transplant policies and Centers of Excellence requirements; support audits and cost report settlement.
Seniority
Mid-level, hands-on IC