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Form of work
SalaryWhy ThedaCare?
Living A Life Inspired!
Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world.
At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you’re interested in joining a health care system that is changing the face of care and well-being in our community, we encourage you to explore a future with ThedaCare.
Benefits, with a whole-person approach to wellness –
- Lifestyle Engagement
- e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
- Access & Affordability
- e.g. minimal or zero copays, team member cost sharing premiums, daycare
About ThedaCare!
Summary :
AR Specialist for our retail pharmacy service line. Prior work experience as a pharmacy technician highly recommended. Focus will be with payor reimbursement, reporting, Epic build, and patient detailing. Role is hybrid with both onsite and remote opportunities. Position will work very closely with retail and 340B pharmacy operations.Job Description:
KEY ACCOUNTABILITIES:
1. Performs comparative analysis for accuracy of bill before submission to appropriate parties (i.e., charges, subscriber data, diagnosis/procedure codes, and late charges).
2. Processes claims in a timely manner according to contracts, regulations, department standards, and form requirements.
3. Generates phone calls to all parties to check status of unprocessed, unpaid, or rejected claims ensuring accurate and timely reimbursement.
4. Processes variety of correspondence from all parties taking appropriate steps to expedite timely resolution of claims payment.
5. Verifies insurance/payer and patient demographic information for accuracy of data collected at time of registration when appropriate. Inputs verification data to complete in-house claims generation of billing forms.
6. Re-bills accounts when new information is received requiring account updates with appropriate demographic and third party information to ensure payment. Updates patient record to indicate changes made.
7. Reviews internal and external reports for claims status.
QUALIFICATIONS:
- High School diploma or GED preferred
• Must be 18 years of age •
PHYSICAL DEMANDS:
• Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance • Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties WORK ENVIRONMENT: • Climate controlled office setting with daily movement throughout the facility • Interaction with department members and other healthcare providers
