Home Infusion Business Coordinator

Munson Healthcare•Traverse City, MI

1d•Onsite

About The Position

Serve as the Pharmacy Home Infusion Business Coordinator, overseeing the financial operations of the Home Infusion program and ensuring services are set up to maximize reimbursement while accommodating each patient’s clinical needs and insurance coverage. Ensures compliance with Munson Medical Center and Home Health policies, Medicare enrollment and revalidation, CHAP accreditation standards, and all payer regulatory requirements. Leads and manages the full Home Infusion revenue cycle, including registration, verification, authorizations, charge entry, CMNs, billing, collections, compliance, reporting, and chargemaster maintenance. Negotiates, maintains, and monitors third-party payer contracts, ensuring timely renewals, modifications for new medications, and financial benefit to the organization; audits claims and resolves denials to optimize reimbursement. Provides operational and financial leadership, including monthly financial reporting, budget forecasting, staff training and support, policy and process development, quality improvement collaboration, and coordination with clinical teams and hospital case managers.

Requirements

Bachelor's degree in Business Administration, Accounting, Information Systems, health related field or equivalent work-related experience
Five years working in the health care field
Revenue cycle experience
Home Infusion Therapy experience
Third Party Contracting experience

Nice To Haves

highly desired

Responsibilities

Overseeing the financial operations of the Home Infusion program
Ensuring services are set up to maximize reimbursement while accommodating each patient’s clinical needs and insurance coverage
Ensuring compliance with Munson Medical Center and Home Health policies, Medicare enrollment and revalidation, CHAP accreditation standards, and all payer regulatory requirements
Leading and managing the full Home Infusion revenue cycle, including registration, verification, authorizations, charge entry, CMNs, billing, collections, compliance, reporting, and chargemaster maintenance
Negotiating, maintaining, and monitoring third-party payer contracts, ensuring timely renewals, modifications for new medications, and financial benefit to the organization
Auditing claims and resolving denials to optimize reimbursement
Providing operational and financial leadership, including monthly financial reporting, budget forecasting, staff training and support, policy and process development, quality improvement collaboration, and coordination with clinical teams and hospital case managers