(Archived) Billing & Reimbursement Specialist III - Accredo Needed in Orlando, FL

Have you heard? Express Scripts and Accredo Specialty Pharmacy are now part of Cigna. Together, we’ve got big plans. We want to change health care to make it more affordable, more personalized, and more focused on helping the whole person to achieve better health outcomes. And that’s only the beginning. Read on to learn more about working with us.

As a Billing and Reimbursement Specialist III, you’ll be part of a dedicated team which is using knowledge on CMS regulations and Accredo’s line of Specialty Pharmacy business as the first-line receiver/monitor/screener of new or revised governmental regulations that can potentially affect Accredo’s Billing and Collections business. You’ll also receive, log, and initially process requests for assistance with clinical appeals on Core/Oncology and selected Advanced Therapy medications.

Here’s a little more on how you’ll make a difference:

• Screening incoming communications for relevancy and importance, then channel them to the next levels within the regulatory team for processing.
• Monitoring the regulatory team’s communication portals (regular mail, JP Morganbox, email, and faxes) for incoming communications.
• Receiving and initially process requests for assistance with clinical appeals for Core/Oncology a few advanced therapy medications (coagulation factors), then channels them to the next level within the team for further processing.
• Responding to internal requests for clarification/guidance on established guidance and communication, using resources from the Medicare SharePoint site, Drug Database, and others. Acting as a back-up data-entry person for the team for information that needs to be logged and entered into the spreadsheets.
• Sending appeals packages out via web-portal (uploading onto Connex, etc.), Certified mails, regular mail, FedEx or faxes spreadsheet.
• Performing other tasks as assigned by leadership

What You Should Have:

• High School Diploma or GED required
• 3 – 5 years of relevant experience working with Medicare/Medicaid on billing/collection/appeals.
• Basic PC skills, including Microsoft Excel, Word, Outlook, PowerPointand the ability to search the internet effectively.
• Detailed oriented, good organizational skills, good verbal and written communication skills, good email etiquette.

What you’ll love about working here:

• Fun, friendly, and unique culture – Bring your whole self to work every day!
• Great working environment in our Dublin office
• Choice of three unique medical plans
• Prescription Drug, Dental, Vision and Life Insurance
• Employee Contributions for HRA and HSA accounts
• 401K with Company Match
• Paid Time Off and Paid Holidays
• Tuition Assistance