Analyst, Billing - DS

Walmart • Bentonville, AR

4d • $26 - $51 • Onsite

About The Position

Analyst, Billing - DS The Health and Wellness Billing Team is looking for a task-oriented individual with acute attention to details who excels at prioritization and collaboration. As a Billing Specialist II, you will respond to third-party pharmacy audit requests, research claim details, defend pharmacy recoupments and issue corrective actions and compliance guidance to pharmacy associates. Reporting to the Billing Manager, you will communicate potential concerns, risks and trends while applying critical thinking skills to identify potential operational or procedural solutions. Who we are: Pharmacy Analysts respond to third-party payer audit requests, investigates and challenges determinations, while capturing insights to drive actionable intelligence to mitigate risk and promote pharmacy compliance adherence. What you’ll do: Support Health & Wellness in responding to third party audit requests and investigations by verifying billing and claim details for third party payers; gathering data and prescription records; tracking audit requests; and ensuring accuracy of data, discrepancies, and recoupments. Complete work assignments and priorities in Health and Wellness Audit by using policies, data, and resources; collaborating with managers, coworkers, customers, pharmacies, and other business partners. Identify priorities, deadlines, and expectations; carry out tasks; communication of progress and information; determine and recommend improvement opportunities; and adapt to and learn from change, difficulties, and feedback. Identify and monitor past, present, and future risks in the audit of groups under review; translating audit findings; gathering proper appeal documentation; and ensuring audit request deadlines are met. Maintain and store HIPAA related records that must comply with Federal and Corporate requirements.

Requirements

• Subject matter expert in Pharmacy space.
• Moderate to advanced Excel skills
• Process-oriented with a keen eye for identifying opportunities to streamline workflows for greater efficiency and effectiveness.
• Critical thinking and problem solving.
• Strong communication skills, enabling effective collaboration with leaders and stakeholders.
• Organized and disciplined, with the ability to manage multiple projects simultaneously while delivering strong results.
• Bachelor’s degree in Business Administration or a related discipline, Healthcare, Compliance, or 3 years’ experience in healthcare, medical billing, audit, compliance, or pharmacy field.
• Associate’s degree in Business Administration, Finance, Accounting, or related field OR 1 year’s experience in accounting, medical billing, medical coding, or related area.

Nice To Haves

• Familiarity with AI applications
• Shows adaptability and embraces a growth mindset.
• Driven to execute and act quickly

Responsibilities

• Respond to third-party pharmacy audit requests
• Research claim details
• Defend pharmacy recoupments
• Issue corrective actions and compliance guidance to pharmacy associates
• Communicate potential concerns, risks and trends
• Apply critical thinking skills to identify potential operational or procedural solutions
• Support Health & Wellness in responding to third party audit requests and investigations by verifying billing and claim details for third party payers
• Gather data and prescription records
• Track audit requests
• Ensure accuracy of data, discrepancies, and recoupments
• Complete work assignments and priorities in Health and Wellness Audit by using policies, data, and resources
• Collaborate with managers, coworkers, customers, pharmacies, and other business partners
• Identify priorities, deadlines, and expectations
• Carry out tasks
• Communicate progress and information
• Determine and recommend improvement opportunities
• Adapt to and learn from change, difficulties, and feedback
• Identify and monitor past, present, and future risks in the audit of groups under review
• Translate audit findings
• Gather proper appeal documentation
• Ensure audit request deadlines are met
• Maintain and store HIPAA related records that must comply with Federal and Corporate requirements

Benefits

• At Walmart, we offer competitive pay as well as performance-based bonus awards and other great benefits for a happier mind, body, and wallet.
• Health benefits include medical, vision and dental coverage.
• Financial benefits include 401(k), stock purchase and company-paid life insurance.
• Paid time off benefits include PTO (including sick leave), parental leave, family care leave, bereavement, jury duty, and voting.
• Other benefits include short-term and long-term disability, company discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more.
• You will also receive PTO and/or PPTO that can be used for vacation, sick leave, holidays, or other purposes.
• Live Better U is a Walmart-paid education benefit program for full-time and part-time associates in Walmart and Sam's Club facilities.
• Programs range from high school completion to bachelor's degrees, including English Language Learning and short-form certificates.
• Tuition, books, and fees are completely paid for by Walmart.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 1-10 employees