Job Details

Billing Analyst amp Reimbursement Specialist III - Accredo

Company name
Express Scripts Holding Company

Location
Warrendale, PA

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Billing Analyst & Reimbursement Specialist III - Accredo

in

Warrendale

Pennsylvania

POSITION SUMMARY

Utilizes advanced knowledge to prepare and review claims approaching timely filing to ensure billing accuracy and to edit, bill and collect payment on outstanding claims in pursuit of reducing the company's accounts receivable. Requires complete understanding of the billing and collection processes and little supervision for routine work.

ESSENTIAL FUNCTIONS

Prepares and reviews claims to ensure billing accuracy according to payor requirements, including but not limited to codes, modifiers, pricing, dates and authorizations.

Pursues collection activities to obtain reimbursement from payors and/or patients. Contacts payor to request overrides, retro authorizations, additional documentation, window extensions, etc. to ensure invoice has necessary elements for reimbursement or to work a rejected claim (denial).

Frequent follow up with payers and/or patients on outstanding accounts.

Responds to billing inquiries and questions relating to patient accounts.

When needed, escalates delinquent and/or complex claims to Sr. Billing & Reimbursement Specialists for further guidance

QUALIFICATIONS

HS Degree (or equivalent)

3-5 years relevant experience

Strong organizational skill

Attention to detail

Ability to communicate effectively both orally and writing

Ability to review data and recognize trends

Knowledge of Medicare reimbursement practices preferred

PC Skills including Microsoft Outlook, Excel, Word and Internet

Able to use Excel proficiently and have the ability to do basic math

Requires basic knowledge of the billing and collection processes and general supervision for routine work

Experience with Managed Medicare payers preferred

Detail oriented and strong organizational skills

Self-starter and team player

Focus on quality and service

Demonstrated ability to meet multiple deadlines and manage a heavy workload

Integrity to handle sensitive or confidential information is critical

ABOUT THE DEPARTMENT

If your niche is in financial reporting and analysis, underwriting, cash management, audit, or investor relations, our Finance department may be a perfect fit for you. Our teams within Finance work together to ensure our spending stays on track, and that we remain a profitable industry leader. We’re always on the lookout for innovative people who think outside the box to join our team.

ABOUT EXPRESS SCRIPTS

Advance your career with the company that makes it easier for people to choose better health.

Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes. Join the company that Fortune magazine ranked as one of the Most Admired Companies in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services. We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.

Express Scripts is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation. Express Scripts is a VEVRAA Federal Contractor.

Company info

Express Scripts Holding Company
Website : http://www.express-scripts.com

Company Profile
Abbott Diabetes Care communicated a recall of certain FreeStyle® strips used in the FreeStyle® Blood Glucose Meter built into the OmniPod Personal Diabetes Manager (PDM). They have also recalled the FreeStyle Flash® Meter and FreeStyle® Classic meters. Both recalls are being issued because glucose level readings using these products may provide erroneously low results which if not recognized may pose significant risks to your health.

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