Medical Billing and Collections Analyst

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.

The Medical Billing and Collections Analyst will work all facets of medical and pharmacy accounts receivable including collection of assigned accounts, claim submission, denial and credit balance management. This role will also help guide a team of A/R Specialists responsible for analysis and collection of outstanding receivables in accordance with department collection metrics and productivity standards.

Key Responsibilities

• Manages high volume collections and follow-up activity; analyze and resolve complex reimbursement issues to ensure timely resolution and accurate reimbursement

• Submits timely appeals following established payer policy to resolve claim denials with a goal of one contact resolution

• Negotiates payment utilizing thorough knowledge of payer contract terms

• Identifies key stake holders or primary contacts within CMS, Commercial and Third Party Payer communities to drive more effective processes

• Evaluation/Correction of billing edits, claims transmission, rejections and other claim functions

• Effectively prioritize and manage outstanding refund requests and overpayments to support contract and legal adherence with all payers including Medicare and Medicaid

• Acts as a knowledge resource for AR team members

• Responds to process related queries and manage 1st level escalations

• Investigates collection issues internally; and provide representation when needed of the Accounts Receivable area to internal departments

• Prepares and presents recommendations for issue resolution to supervisor, based on best practices and expertise; leads implementation of solution

• Participates in weekly and monthly meetings and provide management with account status and resolution activity on unpaid aged balances to ensure timely resolution and minimize bad debt reserve

• Participates in ad hoc projects

• Trains new hires and encourages excellent A/R follow up skills and work ethic

Minimum Requirement

Degree or equivalent and typically requires 2+ years of relevant experience.

Education

An Associate's Degree (or higher) in a related field is desired, or equivalent work experience in a related field.

Critical Skills

• 2+ years recent pharmacy or physician healthcare receivables/collections experience; experience in a senior role preferred

• Advanced knowledge of Medicare/Medicaid and commercial insurance billing and reimbursement policies/guidelines

• Demonstrated experience performing detailed account research, analyzing EOBs and remittance advice and ability to effectively problem solve high dollar claims for quick resolution

• Knowledge of general accounting principles and strong proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint, Teams, and SharePoint)

Additional Skills

• Strong communication skills and ability to clearly convey intricate account information

• Ability to identify root cause and resolve trends and issues with minimal supervision

• Autonomous, proactive and requires very minimal supervision

• Possess high level of critical thinking skills

• Ability to adapt to urgent deadlines or rapidly changing priorities

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. For more information regarding benefits at McKesson, pleaseclick here.

Our Base Pay Range for this position

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!