Infusion Analyst

Physicians East pa; North Carolina; On-site; USD 55,000 - 85,000; Full time

Job summary

Physicians East in Greenville, NC is seeking an Infusion Analyst to support infusion and chemotherapy services, manage drug pricing, reimbursement, and ensure coding accuracy.

The role emphasizes collaboration with physicians, clinical staff, managed care, and operations, with a focus on regulatory compliance, cost control, and patient financial communication.

Candidates should be detail-oriented, observant of regulatory changes, and capable of producing timely reports.

Qualifications

• Excellent communication and organizational abilities are required.
• Ability to identify process gaps and propose solutions.
• Strong integrity and initiative in a collaborative setting.

Responsibilities

• Collaborate with multiple departments to optimize workflows.
• Conduct drug formulary research and perform dosage calculations.
• Monitor chemotherapy and infusion drug purchasing and inventory.
• Ensure patient accounts and authorizations follow policy.
• Prepare reports and analyses using required software.
• Coordinate with drug manufacturers on reimbursements and pricing.
• Review physician orders for accuracy in diagnoses and codes.

Skills

Communication skills

Team collaboration

Attention to detail

Regulatory knowledge

Problem-solving

Job description

Job Description

Job Title: Infusion Analyst

FLSA Status: Non-exempt

About us

Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.

Location & commitments

FT/PT/Temp/PRN role based at our Greenville (other) location, Monday-Friday, 8a.m. – 5 p.m.

Overtime may be required to ensure patients are taken care, tasks are completed, and calls are returned in a timely manner.

Weekend work is rare but can occasionally be necessary.

Supervision Received: Reports to Department Coordinator, Operations Supervisor, Operations Manager, and Reports to Director of Operations.

Supervision Exercised: None.

Typical Physical Demands: Work is performed in an office environment with constant interruptions. Sedentary work in front of a computer screen is required daily. The position requires extreme concentration to specific details to avoid costly errors. Travel to different locations and PODs is required.

Typical Working Conditions: Normal office environment

About the role

• Ability to form positive and collaborative relationships with all levels in the organization.
• This position requires strong organizational and excellent communication skills as well as being highly motivated and detail oriented.
• Possess the ability to identify gaps or problems in business processes and develop ideas to resolve them.

• Must have a strong sense of team commitment, which includes meeting deadlines, punctuality and excellent follow-through and feedback.
• Must display a high level of integrity and initiative.
• Ability to perform research and understand complex regulatory documents and legal language.
• Strong relationship building skills with the ability to delegate and mentor.

Responsibilities

• Works with each department (Physicians, clinical staff, managed care, operations, and insurance) to create and maintain open communication to optimize work performance and productivity.
• Individual should have a strong background in drug formulary and can perform medical dosage calculations.
• Monitor the purchasing of chemotherapy, infusion drugs.
• Ensure patient accounts are current and authorization process is being followed per policy and procedure guidelines.
• Maintain monthly records and reports for all infusion drugs. Meet with leadership and various departments as needed.
• Work with drug companies and their representatives in relation to drug reimbursement.
• Responsible for checking all drug prices and updating any drug contracts associated with discounts and or rebates.
• Responsible for screening the physician’s order for each drug regiment to ensure all diagnosis codes reported accurately reflect the patient’s condition.
• Responsible for checking patient’s accounts periodically to assure that drugs are being properly coded and reimbursed accordingly.
• Monitor various aspects of contract reimbursement and investigates differences between expected and actual reimbursement.
• Ensure that after careful evaluation of each drug regimen a reasonable profitability will be made.
• Keep abreast of new chemotherapy and other infusion drugs and J-codes. Responsible for informing coders and insurance department of any changes.
• Investigate new Patient Assistance Programs and work with such programs to aid patients with financial and therapeutic needs.
• Stay abreast of active Patient Assistance Programs and/or grant deadlines and follow through on behalf of the patient to ensure funding is fully recognized.
• Collect and post monies on Infusion and Chemotherapy services.
• Partner with patients to ensure a full understanding of Infusion and Chemotherapy services and financial expectations.
• Working knowledge of ICD-10 and CPT4 procedural coding systems.
• Keep abreast of regulatory and contract changes affecting Medicare, Medicaid, and managed care reimbursement.
• Prepares reports and analysis as required using necessary software.
• Identify and communicate to management any concerns, which could result in an adverse impact to the company’s cash flow.
• Acts as a liaison to the software vendor and IS to identify and correct system problems and to advise of system upgrades.
• Participates in s