Request a Benefit Level Exception (BLE) or a Single Case Agreement (SCA) as appropriate from the UW Medicine Contracting Department for non-contracted health plans + Obtain all necessary information, including clinical documentation, required by payors for approval of different transplantation phases, including benefit verification, payor authorization, referrals, precertification, and case management + Communicate with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems; initiate communication with appropriate agencies and clinical staff for appeal of denials; Conduct required follow-up on all initiated prior authorizations in an effort to obtain the final authorization + Meet with transplant candidate, potential living donors and/or family to explain insurance coverage, treatment costs, and hospital billing policies + Ensure that adequate insurance benefits or funding arrangements are in place prior to transplant. **WORK SCHEDULE** + Full-time, 40 hours/weekly, + M - F, Hybrid Days (3 days in office, 2 day from home) + Office located at UW Medical Center - Montlake **POSITION HIGHLIGHTS** + Conveniently located near public transportation + Make a difference for the patients and employees we serve + Opportunity to provide career growth **PRIMARY JOB RESPONSIBILITIES** + Obtain and document detailed patient insurance benefit information for all phases of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up Clinic visits, and travel and lodging, if necessary + Obtain all necessary authorizations from payers, verifying transplant coverage and other medical benefits and obtaining referrals and authorizations if required.