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Billing Auditor - Senior

at CVS Health

Posted: 1/11/2020
Job Reference #: 1152476BR
Keywords: billing

Job Description

Job Description
Omnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation.

What We Do

Directly and through our subsidiaries, Omnicare provides a broad array of pharmacy related services to Long Term Care (LTC) facilities and to other customers in the healthcare environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

As a Key Account Billing Auditor, you will be responsible for managing relationships with assigned National Accounts and Account Managers. You will also perform pharmacy pre-billing and post-billing audits and prepare trending reports on behalf of the customer and/or Omnicare.

Your key duties include:
-Analyze and audit the proper execution of the covenants of the pharmacy contract agreement on all assigned accounts.
-Process evaluation to identify areas of opportunity and process improvement.
-Evaluate facility invoices and build action plans with pharmacy when applicable.
-Review facility non-covered, house charges, IV charges and additional reports to ensure contract compliance.
-Collaborate with Strategic Account Executive (SAE) on customer issue resolution and hold regular meetings with SAE and/or customer.

Required Qualifications
-Minimum of 3 years of Medicare, Medicaid and Medicare part D experience.
-A minimum of 3 years of long term care billing experience.

Preferred Qualifications
-Working knowledge of Omniview, MicroStrategy, and other pharmacy operating systems.
-Understanding of pharmacy policy and procedures.
-Ability to build credible relationships with customers and/or business partners.
-Strong decision making and organizational skills, ability to create and execute action plans.
-Excellent time management skills including planning and ability to set, maintain and meet strict deadlines.
-Proficiency with Windows, MS Excel, MS Access, and MS Power Point; ability to learn and apply job related healthcare and other software.

Bachelors degree or equivalent work experience.

Business Overview
It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!