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Accredo- Sr. Billing & Reimbursement Specialist

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POST DATE 8/18/2016
END DATE 10/12/2016

Express Scripts Warrendale, PA

Warrendale, PA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
High School Diploma or GED


Schedule: Full-time

Job ID: REQ20003680


The Sr Billing and Reimbursement Specialist is responsible for various processes/tasks to ensure ongoing accuracy of claim center data within the Accredo financial system. The efforts of this position result in accurate billings for services rendered. Responsible for reviewing and troubleshooting client set up issues affecting billing. Maintains subject matter expert status with regards to claim center and pricing set up processes for the company, and will handle escalated issues and serve as mentor to the other Billing & Reimbursement Specialists.


* Review and process incoming requests from the business regarding billing, pricing, and/or coding requirement changes.
* Reviews specific billing, pricing, coding, conversion, and coverage rules after contract loading to ensure information entered matches contract
* Reviews and analyzes new contracts/amendments, and prepares information for loading into financial system
* Maintain and process client quarterly pricing updates
* Work closely with patient access, billing, account management, and collection teams to resolve client billing set up issues.
* Act as liaison between business and external clearinghouse to set up/maintain electronic billing formats.
* In absence of supervisor, acts as liaison between staff and manager
* Handles complex tasks or urgent problems in addition to daily workload
* Resource for team to get questions answered. Assists with the training of new employees for specific tasks.


* HS degree with equivalent work experience or degree in Accounting or Finance
* 4 - 6 years in Healthcare billing and collections setting
* Ability to use Microsoft Outlook, Excel and Word
* Strong organizational skills and attention to detail
* Ability to communicate effectively both orally and in writing
* General knowledge of Healthcare terminology and medical billing
* Ability to work under little supervision and mentor other team members when needed.


A leading provider of specialty pharmacy services, Accredo improves care for patients through behavioral and clinical expertise.

Accredo offers a broad range of healthcare products and services for individuals with chronic health conditions, such as growth hormone deficiencies, hepatitis C, hemophilia, oncology, multiple sclerosis and rheumatoid arthritis. It also provides comprehensive patient management services, including clinical care management programs, counseling, education, outcomes measurement, social services and reimbursement services.


Advance your career with the company that makes it easier for people to choose better health.
Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes.
Join the company that Fortune magazine ranked as one of the 'Most Admired Companies' in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services.
We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.
Express Scripts is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation.
Express Scripts is a VEVRAA Federal Contractor.

Express Scripts is an EOE
Express Scripts is an Equal Employment Opportunity employer and does not discriminate in employment opportunities or practices on the basis of race, creed, color, religion, sex, national origin, nationality, ancestry, age, disability or status as a disabled veteran or veteran of the Vietnam era, pregnancy, affectional or sexual orientation, gender identity or expression, marital status, status with regard to public assistance, veteran status, citizenship or membership in any other legally protected class. None of the questions in this application are intended to elicit information regarding any protected characteristics, nor imply any limitation, illegal preferences or discrimination based upon non-job-related information or protected characteristics.Applicants must be able to pass a drug test and background investigation and, depending on position requirements, a Department of Defense background investigation. AA/EOE.


One of the largest pharmacy benefits management (PBM) companies in North America, Express Scripts administers the prescription drug benefits of millions of health plan members in the US and Canada. Express Scripts processes claims for about 750 million prescriptions per year, designs drug plans, and offers such services as disease management programs and consumer drug data analysis.

Company Size:
10,000+ Employees
Health Care
Social Media:
1 Express Way
St. Louis, MO 01803
St. Louis, MO 63121

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