Analyst, Billing - DS at Walmart

Analyst, Billing - DS

The Health and Wellness Billing Team is looking for a task-oriented individual with acute attention to details who excels at prioritization and collaboration. As a Billing Specialist II, you will respond to third-party pharmacy audit requests, research claim details, defend pharmacy recoupments and issue corrective actions and compliance guidance to pharmacy associates. Reporting to the Billing Manager, you will communicate potential concerns, risks and trends while applying critical thinking skills to identify potential operational or procedural solutions.

Pharmacy Analysts respond to third-party payer audit requests, investigates and challenges determinations, while capturing insights to drive actionable intelligence to mitigate risk and promote pharmacy compliance adherence.

What you'll do:

• Support Health & Wellness in responding to third party audit requests and investigations by verifying billing and claim details for third party payers; gathering data and prescription records; tracking audit requests; and ensuring accuracy of data, discrepancies, and recoupments.
• Complete work assignments and priorities in Health and Wellness Audit by using policies, data, and resources; collaborating with managers, coworkers, customers, pharmacies, and other business partners. Identify priorities, deadlines, and expectations; carry out tasks; communication of progress and information; determine and recommend improvement opportunities; and adapt to and learn from change, difficulties, and feedback.
• Identify and monitor past, present, and future risks in the audit of groups under review; translating audit findings; gathering proper appeal documentation; and ensuring audit request deadlines are met.
• Maintain and store HIPAA related records that must comply with Federal and Corporate requirements.

Qualities we are looking for:

• Subject matter expert in Pharmacy space.
• Moderate to advanced Excel skills
• Process-oriented with a keen eye for identifying opportunities to streamline workflows for greater efficiency and effectiveness.
• Critical thinking and problem solving.
• Strong communication skills, enabling effective collaboration with leaders and stakeholders.
• Organized and disciplined, with the ability to manage multiple projects simultaneously while delivering strong results.

Skills that are a Plus:

• Familiarity with AI applications
• Shows adaptability and embraces a growth mindset.
• Driven to execute and act quickly

Minimum Qualifications: Bachelor's degree in Business Administration or a related discipline, Healthcare, Compliance, or 3 years' experience in healthcare, medical billing, audit, compliance, or pharmacy field.

Preferred Qualifications: Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.

Primary Location: 2608 Se J St, Bentonville, AR 72712, United States of America

Walmart and its subsidiaries are committed to maintaining a drug-free workplace and has a no tolerance policy regarding the use of illegal drugs and alcohol on the job. This policy applies to all employees and aims to create a safe and productive work environment.