PBM Billing Specialist Senior

Elevance Health•Cincinnati, OH

11d•$19 - $35•Remote

About The Position

The PBM Billing Specialist Senior is responsible for assembling and maintaining all necessary documentation for billing purposes. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.

Requirements

High school diploma or equivalent and minimum of 3 years billing and collections experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

PBM Billing experience.
Proficient with Microsoft Excel.
AS in accounting.

Responsibilities

Maintains billing system database.
Identifies, analyzes and reconciles discrepancies in data.
Posts to sub ledgers.
Coordinates account eligibility with Membership areas and provides billing information to internal and external contacts and first line collections.
Professional and timely oral or written communication to internal and external customers.
Fully proficient with daily tasks and is able to handle more complex billing situations with minimal guidance and provide recommendations for decision making.