Patient Reimbursement Coordinator I-Infusion

UW Health Care Direct Job Opportunity

UW Health Care Direct has been an affiliate of UW Health since 1994. In July of 2020 UW Health Care Direct (formerly known as Chartwell Midwest Wisconsin) officially consolidated all community-based home health services to Chartwell from UW Health and Unity Point Health leading to the establishment of UW Health Care Direct. UW Health Care Direct is dedicated to providing home health care services in the Dane County area, ensuring the highest quality of care for the community.

Position Summary

This position performs initial patient financial and insurance verification and follow-up. Serves as communication liaison between team members, third party payers, patients, and billing for all financial arrangements. Works closely with referral sources and patients regarding patient financial responsibilities.

Essential Job Knowledge

• Performs initial and ongoing insurance verification and authorization for patient referrals in a timely and effective manner.
• Communicates effectively with referral sources regarding patient financial responsibilities and insurance coverage.
• Communicates with patients regarding financial responsibility both verbally and in writing.
• Performs price negotiations (including self-pay arrangements) in the best interest of the patient with respect to the UW Health Care Direct business when applicable.
• Understands Medicare coverage principles and requirements for covered and non-covered therapies.
• Understands coverage principles and requirements for Wisconsin Medicaid.
• Understands drug and per-dem pricing as it relates to home infusion.
• Communicates patient information to team members in a timely manner.
• Promptly documents all insurance and authorization information in accordance with company policy and procedure.
• Performs ongoing insurance verification and authorization extensions on existing patients in a timely and accurate manner.
• Collaborates efficiently with Reimbursement to troubleshoot patient specific Accounts Receivable issues.
• Performs critical evaluation of vended patient cases and keeps management apprised of trends or issues, as applicable.
• Successfully completes initial and ongoing organizational and department education, training, and competency requirements.
• Infection Control: Understands, demonstrates, and follows organizational infection control guidelines (CDIC).
• Quality: Focuses on improving processes and champions efficiency in daily work activities.
• Safety: Promotes a culture of safety by taking accountability for individual actions, including but not limited to, promptly reporting errors or near misses via the organization's occurrence reporting system and participating in developing improved safety processes, as appropriate. (ADM015, ADM016, OPS044, Mission Statement).
• Performs other duties as assigned.

Job Requirements

• High school diploma or equivalent required.
• Minimum of one year of recent experience in discharge planning, case management, or infusion therapy experience preferred.
• Experience and strong knowledge base in infusion or Home Medical Equipment (HME) preferred.
• Excellent organization, interpersonal, communication and customer service skills.

Mission Statement: As healthcare providers, we expect to be the best at what we do and do what is right every time. We hold ourselves accountable to safety, service, and compassion. Through these values, we strive to make a difference in the lives of our patients and employees.