Specialty Transplant Billing Operator

Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Specialty Transplant Billing Operator, you will have the ability to share new ideas and collaborate on projects as an Analyst without the extensive demands of travel.

If so, consider an opportunity with Deloitte under our Project Delivery Talent Model.

Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite and/or remote client service delivery.

Recruiting for this role ends on 11/30/2026

Work you'll do

As a Specialty Transplant Billing Operator / Billing and Claims Operator of Transplant Services you will be responsible for the accurate, timely billing, accounts receivable follow-up, and denial resolution of complex transplant accounts for a large health system.

This role focuses on hands-on execution of hospital (facility) billing operations.

Primary Responsibilities


* Prepare, review, and submit hospital (UB-04/837I) claims for transplant and related inpatient and outpatient services, ensuring coding, charges, and payer requirements are met before release.


* Work assigned A/R inventory through timely follow-up with commercial, Medicare, Medicaid, and managed care payers via portals, phone, and written correspondence.


* Research, analyze, and resolve denials and underpayments, including medical necessity, authorization, timely filing, and coding-related denials.


* Prepare and submit appeals with supporting clinical documentation, contract language, and payer policy references; track appeal status through resolution.


* Validate payer reimbursement against contract terms and flag variances, including transplant case rates, carve-outs, stop-loss, and outlier provisions.


* Verify that authorizations, referrals, and transplant-specific approvals (evaluation, listing, transplant, and follow-up phases) are on file and linked to the correct accounts.


* Coordinate with Patient Access, Coding, Health Information Management, Utilization Review, and the transplant clinical team to resolve documentation and account issues.


* Document all account activity clearly and completely in the billing system to support audit and handoff.


* Escalate payer trends, systemic denial root causes, and process gaps to leadership with supporting examples.

Transplant Specialty Responsibilities


* Bill and reconcile organ acquisition costs by transplant program (kidney, liver, heart, lung, pancreas, and others as applicable), including accurate use of organ acquisition cost center revenue codes and charge capture.


* Maintain organ acquisition cost center billing for Medicare, Medicaid, and commercial payers, including recovery of organ procurement organization (OPO) invoices and related acquisition charges.


* Support Medicare cost report reconciliation by tying organ acquisition billing, usable and non-usable organ counts, and acquisition charges ...