DescriptionAs a Senior Accountant you will utilize existing processes as well as to build new ones to keep track of outstanding balances for a large list of pharmacies. You will collaborate with internal as well as external areas to support the ongoing processes and find ways to make improvements and gain efficiencies. You will be responsible for developing metrics and building reports to reflect historical performance as well as the present results. You will be in direct contact with pharmacies in the Humana network and using your negotiation skills to perform financial recoveries related to over-payments.
NOTE: Candidate needs to be local to Louisville, KY to commute to the office as needed.
- Provide support on a claim level for the pharmacies with outstanding balances. Collaborate with Pharmacy Audit when needed to gain a sufficient understanding of causes for the balances.
- Update various reports on a timely basis.
- Maintain written correspondence related to recoveries. Utilize existing, approved letters and make changes as required.
- Make direct phone calls to pharmacies in Humana’s network to perform financial recoveries related to overpayments and audit adjustments.
- Lead conference calls with internal areas during discussions related to upcoming claim adjustments, pharmacy terminations, fraud and abuse cases, etc.
- Maintain relationship and exchange of information and reports with external collection agency partner.
- Participate in conversations with Humana legal department in cases of unsuccessful attempts to collect through available means.
- Bachelor's degree in Accounting, Finance or equivalent
- 5+ years of technical experience
- Progressive leadership and management experience
- Prior experience within the financial industry
- Master's Degree in Business Administration
- Certified Public Accountant license
Scheduled Weekly Hours40