Express Scripts Holding Company
Billing Analyst & Reimbursement Specialist III - Accredo
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.
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
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.
Express Scripts Holding Company
Website : http://www.express-scripts.com
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