Reimbursement Specialist

Reimbursement Specialist

 

Working Here Says

Something About You.

 

 

Working at Express Scripts says something about your commitment to quality, your integrity, and desire to excel in your career.  Since 1986, many outstanding people have contributed to our success as a Pharmacy Benefits Management leader and Fortune 500 company with over $15 billion in sales.  We have the following opportunity in our St. Louis location.

 

-  Verify eligibility and benefits for all patients, including re-verification of eligibility monthly. Determine and obtain authorization from Insurance Company to allow for proper claim payment. Inform patient of benefits including co-pays and deductibles.

-  Determine appropriate coding for Medical and Pharmacy claims.

-  Determining correct patient responsibility based upon benefit plan and billing patient accordingly

-  Collecting on Medical and Pharmacy claims per patient's benefit plan

-  Send appeals as necessary to obtain proper payment

-  Determine contract status to determine if Letter of Agreement or Contract is necessary

 

Qualifications:

-  MUST have at least 3 years of collections and / or medical billing experience.

-  MUST have at least 1 year of medical coding knowledge; including usage of HCPC, ICD9, CPT coding experience.

-  Certification in Medical Coding *PREFERRED*

-  MINIMUM three years experience and/or knowledge of insurance industry, Pharmacy Benefit Management, appeal processes, knowledge of medical terminology and procedures within the context of claims processing and collections.

-  Previous experience in Medical and Pharmacy claims processing industry desired.

-  Professional written and verbal communication skills.

-  Computer literate (Microsoft Office preferred)

 

Education:

-  High school diploma or equivalent. At least 2 years secondary education preferred.

 

 

We offer a competitive salary and excellent benefits package.  No relocation benefits are offered.  Please e-mail resume (*STATING ?AH-Reimbursement? IN SUBJECT LINE) and salary history to: success@express-scripts.com Visit us at: express-scripts.com.  We are an equal opportunity employer.