About Conduent:Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them.You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.Job Description:Insurance Collections Services Associate II – Pharmacy is responsible for seeking reimbursement/recovering overpayments from third parties, pharmacy providers, PBM’s, healthcare facilities and/or insurance carriers on overpaid NCPDP pharmacy drug claims for CPIS clients.
These claim overpayments are a result of incorrectly paid claims arising from COB issues, data mining, duplicate claim payments, client referrals, etc.
The Insurance Collections Services Associate II – Pharmacy is responsible to meet all performance standards: collection goals, compliance, and production to ensure calls are timely, maximum call time is achieved, and ensures quality results.Insurance Collections Services Associate II – Pharmacy will handle the recovery of pharmacy related Medicare Part D claim overpayments identified through various audits.
Responsibilities include (but are not limited to):Recovery of pharmacy claim overpayments through direct outreach via phone, e-mail, or fax method with pharmacies, PBM’s, insurance carriers, and/or hospice and dialysis facilities.Communicates effectively with other staff/team members.Coordinates collection efforts between the client and the provider, adjusting claims/reversals as required.Develops effective recovery approaches and workflows to maximize recovery opportunities.Communicates with plan carrier regarding Medicare Secondary Payer requirements, as well as Hospice, ESRD and LTC drug exclusions under Medicare Part D.Handles disputes and appeals from carriers, providers and clientsTraining: 2 weeks M-F, 6am – 2:30pm PST / 6:30am – 3pm PSTWork Hours: Monday Friday, 6am – 2:30pm PST / 6:30am – 3pm PSTPay: Min-$17/hourlyFull Time – regular positionEquipment provided [Laptop & Headphones]This a Remote / WFH position Requirements:Must be at least 18 years of age with at least an Associate’s Degree or equivalent combination of education and experience.
.Must pass a criminal background check and drug screening.Must have WIRED internet connection, WIFI is not permitted.
Preferred:Experience with Microsoft Office Excel.Experience with pharmacy PA’s and overrides preferred.Minimum 1-year experience with pharmacy billing/insurance collections.
Additional informationWhere legally permissible, Conduent requires associates to attest to their COVID-19 vaccination status and may require proof of vaccination.Closing:Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the ” Submit” button at the bottom of the form.
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