Under the minimal direction of the Director or Senior Director, Client Excellence, the AR Analyst, Healthcare is a key analytical member of the Operations team. This role is responsible for overseeing the successful conversion of paper remittance to electronic remittance data files. Duties may include analyzing connections and data flow in support of compliance solutions within Healthcare. Partnering with the paper to electronic ratio at a client and payer level, then working to convert paper to electronic remittance; providing pre-filled forms to clients to expedite processing; partnering with the Account Team to ensure the client is aware of all necessary forms and processes required to receive and manage electronic data exchange and convert to electronic remittance; working with insurance carriers to understand their individual requirements, developing and communicating best practices.
Primary Accountabilities:
(25%) Analytical
● Identify conversion opportunities for clients by analyzing and reviewing data and provided documentation for setup needs claims data, manual remittance volume, and payment file data
(60%) Operational
● Communicates with vendor partners (Manufactures and Wholesalers) Pharmacy Benefit Managers and Insurance Carriers to retrieve electronic remittance advice for new clients and/or new client stores sites
● Work with EDI on SFTP setups; Work with NOC on password resets
● Assist with client onboarding and deconversion
● Work closely with new vendors payers to facilitate a successful partnership
● Work with Sr AR Analyst, Payer Conversions and legal department to approve third party agreements to facilitate the receipt of client payment data
● Populate forms and communicate instructions to clients to facilitate conversion based on carrier requirements
(15%) Administrative
● Create and maintain Tracking Logs for all assigned clients
● Follow HIPAA policies and procedures per company guidelines
● Create and maintain documents on the team resource site, as well as the external NCPDP site
• Additional Responsibilities:
• Performs other duties as assigned
• Complies with all policies and standards
Required Qualifications:
•Bachelors Four year college required 3-5 years of related work experience and/or any equivalent combination of experience and training that provides the required knowledge, skills, and abilities needed to complete the major responsibilities/essential functions of the position. required
• Proficient in Microsoft Windows, Microsoft Office, Google Office Suite
Physical Demands
The physical demands described here are representative of those that must be met by an associate to successfully perform the major job responsibilities (essential functions) of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the major job responsibilities. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.
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We are an Equal Opportunity Employer, including disability/vets.
