• Job Description

  Req#: 114112
  Overview
  
  
  Are you a trained finance professional? We at M Health Fairview are looking for you to join our outstanding team at our UMMC West Bank location located in Minneapolis! This benefits eligible position is a 1.0FTE (80 hours/2 weeks) on the day shift with as needed weekend rotations.
  As a member of the Oncology/Infusion team, the Infusion Finance Specialist leads and/or coordinates all financial issues with patients, insurers, referring/attending physicians, care coordinators, pharmacy staff, and other partners related to medications administered in the clinic/infusion center. Verify insurance coverage; assesses level of benefits; acquires payer approvals for high cost drug therapies prior to patient treatment; solves problems with insurers; provides financial counseling and support for patients as needed during their course of treatment.
  Accept and process all referrals, identify payer sources, verify benefit information and acquire initial authorization as needed to begin patient service or to resolve denial of patient service. Follow up on pending unresolved coverage issues and claim denials. Document and communicate to appropriate providers and internal department’s accurate authorization information on current or potential patients.
  Provide outstanding customer service to all internal and external customers.
  Due to organization growth, we have three openings. Each position will support the locations as noted:
  • All Infusion Sites (***Remote*** and as needed at Kasota)
  This position is offering a $5000 incentive!
  
  Responsibilities
  
  
  Using strong knowledge of insurance, revenue cycle and oncology infusion and accordance with department Standard Operating Procedures (SOPs) and any regulatory or compliance requirements:
  • Perform verification of insurance benefits, analysis and identify any potential coverage issues
  • Assure fast, easy access to infusion services while documenting accurate referral and reimbursement (payer) information, coordinating the intake and benefit authorization process
  • Provide financial counselling and support for patients as needed during the course of their treatment communicating options for financial assistance as appropriate.
  • Research to find other programs for payment and/or negotiate with providers and third party payers to provide coverage or exceptions.
  • Assist in resolving problems with payers and provide information and expertise to other departments.
  • Partner with potential international and self-pay patients on any financial or service needs related to their infusion care
  • Coordinate with staff to identify appropriate patients for home and outpatient infusion therapy including payor source, clinical information, and the ability of Fairview Home Infusion to provide a safe environment for infusion therapy.
  Serve as a resource to the affiliations, staff and physicians regarding Fairview’s infusion services. Assist with the coordination of services by communicating effectively and in a timely manner with others.
  Maintain current knowledge of payer requirements and general admitting practices including use of on-line verification applications and initial and ongoing training.
  
  Qualifications
  
  
  The ideal candidate will have experience working with specialty medications, prior authorizations, and/or coordinating work with multiple stakeholders. Communication skills, interpersonal skills & adaptability are critical. Willingness to work in a fast-paced environment, work independently, to grow and develop and to be an integral part of the team is necessary.
  Minimum Education:
  Education
  • Baccalaureate degree in business or healthcare related field or equivalent combination of education and related experience.
  Experience
  • 2 years of revenue cycle, financial counseling or contracting experience using an enterprise software system in healthcare or insurance organization.
  Preferred:
  Additional Requirements:
  Excellent customer service skills, proficient in English language, capable of solving problems effectively, ability to follow policies and procedures, and competent mathematical skills. Pharmacy experience in specialty medications, retail and/or hospital setting preferred.
  We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, sex, gender, gender expression, sexual orientation, age, marital status, veteran status, or disability status. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
  
  EEO Statement
  
  EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

• About the company

  M Health Fairview is the newly expanded academic health system that represents a collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The partnership combines the university’s deep history of clinical innovation and training with Fairview’s extensive roots in community medicine.

Notice