Lead Infusion Coordinator - FT Days - Bronson Healthcare

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If you’re ready for a rewarding new career, join Team Bronson and be part of the experience.

Location

BMH Bronson Methodist Hospital

Title

Lead Infusion Coordinator - FT Days

Job Description:

• Assess financial needs of new and established infusion patients.
• Gather patient documentation for new patient processing
• Verify information on incoming documents for accuracy and completeness
• Contact insurance carrier to verify insurance benefits including but not limited to: drug coverage, out of pocket costs, and medical policies.
• Request authorization for payment from insurance providers, and submit changes based on patient prescriptions.
• Review documents and authorization details from Insurance providers confirming coverage of services; including CPT codes, site of care, and cadence of treatment.
• Responsible to ensure referrals are up to date for patient treatment plans and referral is filled out comprehensively.
• Stay apprised of insurance requirements, policy changes, and resources needed to validate infusion requirements. 
• Scan and upload documents from insurance providers into electronic medical record.
• Track pending claims.
• Utilize repots to determine tasks that require follow up.
• Understands how to identify patient financial responsibility and works closely with financial navigator to ensure that patients are informed of their financial responsibility.
• Follows up on patient balances within established timeframes.
• Takes appropriate action for escalating claims not paid within 60 days or for denials appeals. 
• Collaborates with billing team to assist with documentation for describing bad debt and write off situations.
• Identifies patterns of short-payment or non-payment and brings them to the attention of appropriate supervisory personnel. 
• Collaborates with financial navigator to negotiate payment plans with patients in accordance with company collection policies.
• Oversight of day to day operations of the Infusion Referral Coordinators. 
  • Monitoring quantity of workflow to ensure completion of assignments
• Utilizes leadership skills to support staff, solve problems, and make decisions.
• Ability to facilitate a team and be a team member.
• Demonstrate the ability to identify opportunities for improvement.

Problem-solving skills to critically analyze data and recommend alternate plan of action.

Qualifications

• Bachelor’s degree in Business, Finance, or related field or equivalent experience in the medical field working in the arenas of medical billing, receivables, and collection required.
• CHAA certification preferred
• Knowledge of medical terminology, and CPT, ICD-10 coding.
• Competence with billing, along with completion and filing claim forms.
• Must of excellent computer skills (i.e. Microsoft Office inclusive of Word and Excel).
• Data entry skills (50-60 keystrokes per minute)
• Ability to utilize database and other data collection and reporting software.
• Excellent communication (verbal and written) and organizational abilities.
• Demonstrated experience and thorough knowledge of Medicare health plans, COBRA regulations, Medicaid guidelines, patient assistance programs (PAP) and co-pay assistance programs.
• Must develop positive relationships with clinical staff to maximize the benefit and effectiveness of the financial counseling function.

Additional Job Description

• May require periodic travel to other Bronson locations.
• Work which produces levels of mental/visual fatigue which are typical of jobs that perform a wide variety of duties with frequent and significant uncontrollable deadlines.
• Work may include the operation of and full attention to a personal computer or CRT up to 40% of the time. 
• Involves considerable standing or walking, regular lifting of light-weight objects (i.e. 20 pounds or less) and assisting with heavier tasks such as assisting in lifting and moving patients.
• Minor straining or fatiguing positions must be assumed and some fatiguing physical motions are required.
• Organize and lead department meetings
• Coordinate and oversee activity in the office
• Facilitates the resolution of problematic situations and informs appropriate leadership of action taken.
• Collaborate with other infusion locations inclusive of Ambulatory and Home Infusion to ensure appropriate site of care for referral received.
• Maintain good communication and workflow between infusion centers, home infusion, specialty pharmacy and referral sources, to help ensure new/existing patients are receiving care in a timely fashion.
• Utilizes numerous computer programs including but not limited to Epic, Right Fax, and payor specific sites.
• Facilitate staff access to payor specific sites needed.
• Orient, train and provides education for staff related to referral process, authorization process, referral status, benefit analysis and interpretation, and management of work queues. 
• Acts as subject matter expert for the organization by providing guidance and addressing questions.
• Verification of health plan and physician eligibility and authorization for services.
• Initiates and assures prior authorization for requested services under insurance carrier guidelines.
• Process authorizations using CPT, ICD10 coding.
• Identify and address areas of improvement in referral processing and provide recommendations to improve procedures and enhance processes.
• Monitors work volume, efficiency standards and other management concern for areas of responsibility.  Initiates corrective actions and makes recommendations for changes when necessary. 
• Provide suggesting and give input into both short and long term department plan
• Work with leadership to establish and monitor personal and department goals/plans.
• Responsible for making recommendations to the manager regarding items that affect budget such as increase or decrease staffing needs, equipment and supply purchases and overtime usage.
• Works closely with referring practices, managers, staff and IT to ensure understanding of the referral process and responsibilities.

Maintain staff schedules, manage staff PTO requests, ensuring staffing levels are adequate to maintain service level.

Shift

First Shift

Time Type

Full time

Scheduled Weekly Hours

40

Cost Center

5102 Infusion Center (BMH)

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