- Rogers, AR
What you'll do...Serves as subject matter expert by educating internal teams about bill review process and system changes; providing supporting information and education related to litigation of bill review to defense attorneys; analyzing bill review litigation trends with adjusting teams and legal department to develop solutions for implementation; collaborating with third party administrators to improve processes; drafting letters and explaining review statements for multiple states; educating team and vendor processors on pre-litigation best practices; and participating and leading special projects to enhance bill payment processes. Partners with senior management to plan and analyze business performance by collaborating with internal and external key stakeholders; identifying gaps between business goals and stated corporate objectives; communicating and presenting immediate and future projections, results, risks, and needs to various levels of leadership within Walmart and key partners; providing feedback to senior management regarding assumed level of risk; supporting business unit budget process and strategic business plans; and providing insight on relevant historical trends, expected future events, and retail trends. Directs the development and implementation of strategies for competitive bidding of durable medical equipment by aligning competitive bidding strategies with company objectives and mission; determining products and prices to offer for business growth to align with company operating model and mission; ensuring the mitigation of audit and compliance risks, and partnering with cross-functional teams to ensure standards and other obligations are met. Develops the strategic direction for the billing audit team by providing direction regarding the focus for audits to ensure risks are mitigated; determining new technologies and processes needed to execute audits; leading the audit team to identify areas of opportunity in current processes; working with cross-functional teams to determine and execute needed fixes; analyzing and evaluating efficiency of communication plans; and serving as the subject matter expert for compliance matters. Manages and influences third-party insurance providers to ensure the most effective billing and reconciliation process is used by identifying deviations in industry standards, systems limitations, or regulatory requirements that would affect company compliance and profitability; directing Information Systems Division resources to ensure system compliance; utilizing internal data sources to make decisions; and ensuring accurate collection of funds. Oversees the continuous improvement of operational and system processes for government and commercial billing by conducting program evaluations; assessing past, current, and future parameters of programs; assessing audit requests, billing requirements, reimbursements, and formulary guidelines; engaging all required stakeholders; defining the appropriate action plan; and following up with stakeholders to ensure accuracy and completeness in the billing process. Provides overall direction by analyzing business objectives and customer needs; developing, communicating, building support for, and implementing business strategies, plans, and practices; analyzing costs and forecasts and incorporating them into business plans; determining and supporting resource requirements; evaluating operational processes; measuring outcomes to ensure desired results; identifying and capitalizing on improvement opportunities; promoting a customer environment; and demonstrating adaptability and sponsoring continuous learning. Develops and implements strategies to attract and maintain a highly skilled and engaged workforce by diagnosing capability gaps; recruiting, selecting, and developing talent; supporting mentorship, workforce development, and succession planning; and leveraging the capabilities of new and existing talent. Cultivates an environment where associates respect and adhere to company standards of integrity and ethics by integrating these values into all programs and practices; developing consequences for violations or non-compliance; and supporting the Open Door Policy. Develops and leverages internal and external partnerships and networks to maximize the achievement of business goals by sponsoring and leading key community outreach and involvement initiatives; engaging key stakeholders in the development, execution, and evaluation of appropriate business plans and initiatives; and supporting associate efforts in these areas.
Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications.
Minimum Qualifications: Bachelor's degree in Business Management, Accounting, Project Management, Healthcare Management, or related field and 5 years' experience in insurance claims, accounting, or related area OR 7 years' experience in insurance claims, accounting, or related area. 2 years' supervisory experience.
Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.
Working on cross-functional teams or projects
Masters: Business Administration
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