Sr. Accounts Receivable Specialist (remote)

McKesson; The Woodlands (TX); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is looking for a Reimbursement Specialist to join their dynamic team. This role is vital in ensuring timely and accurate insurance payments, requiring a keen eye for detail and strong communication skills. You'll be responsible for navigating the complexities of insurance claims, collaborating with various departments, and striving for optimal results. If you're passionate about making a difference in healthcare and thrive in a fast-paced environment, this is the perfect opportunity for you to grow and contribute to a meaningful mission in patient care and community well-being.

Qualifications

• 5+ years of experience in healthcare, especially in insurance follow-up.
• Strong knowledge of insurance benefits and accounting skills.

Responsibilities

• Identify and manage insurance payments and denials on accounts.
• Research denials and draft appeals for overturning decisions.

Skills

Healthcare Industry Experience

Insurance Follow Up

Communication Skills

Organizational Skills

Adaptability

Education

High School Diploma or Equivalent

Tools

MS Office

Spreadsheet Applications

Job description

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 the timely and accurate identification of insurance payments and/or denials on outstanding accounts receivable either via phone and/or electronic contact with the payer. Qualified candidates must have excellent written and verbal communication skills, computer literacy, and the ability to multi-task in a fast-paced work environment. Under the direction of the Reimbursement Manager, candidates will be responsible for meeting specified quantity and quality goals for follow up on accounts.

Key Responsibilities

• Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal department and organizational results.
• Strikes a balance between maintaining trustful relationships and ensuring timely payments. Exhibits professionalism and trustworthiness.
• Reviews accounts, takes appropriate action, and documents per departmental standards. Ensures the reason for the denial (clinical, administrative, or technical) is clearly stated on the payment documentation. Handles technical issues and forwards clinical and administrative issues to the appropriate group for review.
• Confers with Billers, as necessary, to obtain additional information/clarification and requests rebills as needed. Confers with Intake, as necessary to obtain retro auth and/or benefits verification as needed.
• Researches denials and determines if there is a legitimate case for overturning the denial, in accordance with the payor’s medical policy or the contract. Drafts and submits appeals using a sound argument for denials that have a reasonable chance of being overturned.
• Informs manager of payor trends or any problems or changes in payor requirements, including any barriers or obstacles.
• Provides clear and concise documentation of every action taken on an account in the system collection notes. Provides balance breakdown to document the status of next responsible party (i.e., primary, secondary payor, patient balance, or credit balance).
• Identifies accounts for advanced due diligence steps or legal placement in accordance with department policy and procedure. Effectively manages inventory in accordance with departmental standards.
• Utilizes contracting modeling and notifies manager if incorrect payments/contractual are being calculated.
• Meets or exceeds stated Performance Indicator Expectations (e.g., productivity, account reviews, agings) as demonstrated on weekly Key Performance Indicator.
• Follows up on assigned delinquent insurance claims. Ensures maximization of collection dollars from insurance companies in accordance with the respective contract.
• Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary. Updates account information accordingly. Follows levels of authority for posting adjustments, refunds, and contractual allowances.
• Uses resources effectively and efficiently. Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.
• Stays current on various payors and industry trends. Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.
• Generates and communicates new ideas and suggestions that will improve quality or service. Demonstrates adaptability and flexibility in the face of changing demands.

Minimum Requirement

Typically requires 5+ years of related experience.

Education

HS Diploma or Equivalent

Critical Skills

• 5+ years of experience in healthcare industry; preferably in insurance follow up and/or collections.
• 5+ years knowledge of insurance benefits which includes, deductibles, co-insurance, out-of-pocket, plan exclusions and prior authorization requirements preferred.
• Accounting experience, reading, writing and arithmetic skills.
• Some knowledge of credit and/or collection policies, practices and systems, as well as familiarity with spreadsheet applications.
• Excellent personal computing skills and a working knowledge of MS Office software.

Additional Skills

• Must be able to communicate effectively, both orally and in writing.
• Must demonstrate ability to work well in a team dynamic as well as independently.
• Must demonstrate adaptability to handle changing priorities in a high volume, fast-paced work environment.
• Must demonstrate exceptional organizational skills and ensure attention to detail at all times.

Salary: 21.58 - 28.77 - 35.96 USD Hourly (Target $25/hour)

B4

Must be authorized to work in the US. Sponsorship is not available for this position.

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.

Our Base Pay Range for this position

$21.58 - $35.96

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!