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Details

+ **Department: Pharmacy Services**

+ **Schedule: Day shift, 40hrs/wk**

+ **Hospital: Wauwatosa Ambulatory Center**

+ **Location: Wauwatosa, WI**

Benefits

Paid time off (PTO)

Various health insurance options & wellness plans

Retirement benefits including employer match plans

Long-term & short-term disability

Employee assistance programs (EAP)

Parental leave & adoption assistance

Tuition reimbursement

Ways to give back to your community

_Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer._

Responsibilities

Counsel patients and/or parties responsible for payment regarding payment responsibilities and options.

+ Explain financial responsibilities for services received, payment options and collection procedures to patients and/or parties responsible for payment.

+ Counsel patients regarding insurance benefits and recommend alternative sources of payment and/or financial assistance when appropriate.

+ Contact insurance carriers or other sources and act as an advocate for the patient.

+ Initiate process for collecting prepays due and perform follow-up to insure maximum collection is achieved.

Requirements

Licensure / Certification / Registration:

Preferred Credential(s):

+ Approved Local Exception. For use with unique Union job requirements only. Remove if not for Union.

+ Certified Application Counselor credentialed from the state of Wisconsin.

Education:

+ High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.

+ Note: Required professional licensure/certification can be used in lieu of education or experience,if applicable.

Additional Preferences

Additional Responsibilities:

+ **Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled services**

+ **Ensures all treatment regimens are medically necessary and meet payer specific policies as part of the authorization process.**

+ **Manages the timely authorization or re-authorization requirements per payer policy, preventing any delay in care** **Validates drug formulary requirements as part of the authorization process. Communicates necessary changes to the appropriate leaders and clinical teams.**

+ **Partners with Financial Advocates and provider offices to optimize patient insurance coverage and maximize reimbursement.**

+ **Identifies patients that may be eligible for Ascension FAP, copay assistance, foundation assistance & manufacturer drug programs.**

+ **Coordinates appeals when regimens are denied at the time of prior authorization. May include direct communication with physicians, pharmacists and patients.**

+ **Maintains a well rounded knowledge of CPT codes, JCodes and ICD-10 codes**

+ **Serves as a resource to staff and external contacts on issues related to authorization processes, payor guidelines, coverage determinations and requirements, and billing.**

Epic experience preferred.** **Familiarity with hospital OP, buy & bill, specialty pharmacy and site of care requirements a plus.** **Desire to continually learn and grow is a must.

Why Join Our Team

Ascension Wisconsin has been providing rewarding careers to healthcare professionals since 1848. Operating 17 hospital campuses and over 100 related healthcare facilities from Racine to Appleton, you will find opportunities that allow you to create a career path you love, all while delivering compassionate, personalized care to the communities we serve.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) (https://www.eeoc.gov/sites/default/files/2022-10/22-088\_EEOC\_KnowYourRights\_10\_20.pdf) poster or EEO Know Your Rights (Spanish) (https://www.eeoc.gov/sites/default/files/2022-10/22-088\_EEOC\_KnowYourRightsSp\_10\_20.pdf) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice (https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp\_%20English\_formattedESQA508c.pdf)

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

This Ministry does not participate in E-Verify and therefore cannot employ STEM OPT candidates.