Reimbursement Specialist/Rep (On-Site)

Macro Helix (McKesson Corporation) • Full-time • Fort Worth, TX, USA - 13501 Park Vista Blvd. (E016) • 2d ago

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

Reimbursement Specialist is responsible for assisting the pharmacy in collections activities of patient accounts. Requires judgment and initiative and the ability to coordinate and identify payment balances between third parties, patient and public/private insurance.

Works in a fast paced, high-volume contact center environment to provide product specific reimbursement support to patients, healthcare providers, patient advocates, and manufacturer representatives. Will frequently interact via telephone with commercial payers to conduct insurance verifications and benefit investigations. Works daily with commercial payers to ensure appropriate coverage and reimbursement in a variety of therapeutic areas. Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits. Obtains payer specific prior authorization documentation, if applicable and facilitates the prior authorization process for patients and healthcare providers. A general understanding of Medicare and Medicaid programs is desired. Position may require, project management and/or account coordination skills depending on the specific program.

Fully onsite position. Monday-Friday 10am-7pm **

Key Responsibilities

Patient follow-up calls for outstanding accounts
Process customer payments by credit cards
Responsible for tracking and monitoring accounts to ensure files are not delinquent
Develop relationships with payer organizations to review and discuss complex/difficult coverage cases etc.
Responsible for working with all parties to collect on complex and large dollar accounts
Initiate write-off and waive requests as necessary, obtaining necessary approvals and update system information
Perform miscellaneous collection functions including payment processing, research/issue follow up, etc.
Audit assigned aging reports to identify delinquent accounts and assess appropriate collection activity, providing a proactive approach to collecting past due receivables
Interacts with various departments, as needed, to support ongoing claims activities and quality improvement efforts
Provide exemplary customer service meeting the standards of McKesson Canada
Builds and maintains relationships at multiple levels across both McKesson and external reimbursement stakeholders to achieve and drive Accounts Receivable success metrics
Adheres to all McKesson policies and procedures as well as federal and regional regulations regarding privacy and health information protection
Accurate data entry into various systems.
Other duties as assigned by Senior Manager

Minimum Requirement

Typically requires 1+ years of related experience

Critical Skills

Healthcare/insurance is preferred
Exceptional and effective communication skills, both written and oral, for internal and external audiences
Highly organized and results-oriented, with ability to multi-task and prioritize workload.
Previous experience in pharmacy cash processing is highly preferred
Proficiency in Microsoft Excel

Salary: 16.58 - 22.10 - 27.63 USD Hourly (Target $22-23.50/hour)

B2

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

Our Base Pay Range for this position

$16.58 - $27.63

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

Join us at McKesson!