EDI Reimbursement Specialist
Walgreens - Deerfield, IL

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EDI Reimbursement Specialist (Job Number: 011717)
At Walgreens, we help people get, stay and live well. That’s our core purpose and the difference we make in people’s lives every day. Our purpose has shaped the direction of our company since Charles R. Walgreen Sr. founded his first drugstore in 1901, and it still does today.

Our team members make that purpose come to life in our more than 8,000 stores in all 50 states, the District of Columbia and Puerto Rico, in our call centers, distribution centers, clinics, specialty pharmacies, infusion and respiratory service locations and corporate offices. In fact, those daily demonstrations of our purpose have helped Walgreens become an industry leader and a household name.

Walgreens has something for everyone who wants to build a successful career. Here, you’ll find supportive co-workers, an innovative environment and the tools you need to expand your skills, help build healthy communities and advance your career.

Job Summary

The Corporate Reimbursement Specialist - EDI is responsible for electronic transactions between our organization and our payers. The payer base includes Medicare, Medicaid, managed care payers, commercial insurance carriers, and patients. They will also assist in completing provider enrollment applications.

Job Responsibilities
  • Assists branch offices in electronic transmission of claims and remittances. Communicates with branch offices on projects extracted to Corporate.
  • Collaborates with branch Reimbursement Department to ensure processes are in place to enable timely and accurate electronic billing and collections.
  • Responsible in completing provider enrollment applications.
  • Responsible in creating user logins for several provider portals.
  • Participates in project progress calls, presenting progress success/failure information with plans of action.
  • Responsible for assisting in the creating and evaluating of documentation and training materials.
  • Responsible for maintaining confidentiality of patient and proprietary information. Complies with legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary Walgreens-Option Care information.
Basic Qualifications & Interests
  • High School Diploma/GED and at least 2 years of experience in the healthcare industry
  • Experience in provider enrollment
  • Experience working with Medicare and Medicaid
  • Experience in Brightree, CPR+, Dezine, i-Emphsys, DayTech or other medical billing software
  • Experience identifying issues and recommending/implementing ways to resolve issues and problems
  • Intermediate skill level with Internet Explorer and comfortable navigating provider portals
  • Experience communicating both verbally (on the phone, one-on-one, to groups) and in writing (emails, letters, reports, presentations) to various audiences (work group, team, company management, prospective acquisitions, external clients)
  • Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling)
  • Intermediate level skill in Microsoft PowerPoint (for example: applying a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font)
  • Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns)
  • Experience developing ways of accomplishing goals with little or no supervision, depending on oneself to complete objectives and determining when escalation of issues is necessary
  • Willing to travel up to 25% of the time for business purposes (within state and out of state)

Walgreens - 21 months ago - save job
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At Walgreens, we help people get, stay and live well. That is our core purpose and the difference we make in people's lives every day. Our...