Job Description:
Job Summary:
Responsible for Provider Enrollment process management, compliance management, and client/customer relationship management. Adhere to federal and state regulations regarding the initial application for and the renewal of the provider status to service and bill at all of the Walgreen pharmacies. Process accurately, completely, and timely all initial applications or renewal applications required for the billing of pharmacy products and services at the commercial, state, and federal level. Ensure all contacts receive efficient and courteous service.
Job Responsibilities:
+ Processes, either on paper or online, all pharmacy enrollment applications accurately, completely, and timely to support pharmacy operations. Serve as a subject matter expert related to the enrollments of their assigned state Medicaids.
+ Research applicable enrollment or participation rules and regulations within each state funded programs, not limited to Medicaids, for changes.
+ Maintain current pharmacy demographic, ownership, and managing employee/officer information on file with NCPDP, NPPES, and the various state and governmental payers and DMEPOS Accreditation vendor
+ Processes, either on paper or online, all SNAP and WIC enrollment applications accurately, completely, and timely to support operations
+ Serves as first escalation point for enrollment problem resolution. Anticipates the needs of the customer, takes ownership of the issue and proactively identifies solutions. Seeks guidance from supervisory or managerial staff only for the most complex or critical escalated questions or problems.
+ Investigate, troubleshoot, and solve operational issues as it relates to being a recognized billing provider.
+ Apply WAG policies in the security of the personal information and the internal Legal guidance for the credentialing responses.
+ Obtains and maintains governmental portal web access for enrollments, prior auths, claim status, and remittance detail for pharmacy personnel and HAR team members
+ Coordinates with other functional and operational areas as necessary
+ Contacts state Medicaid offices or processors, as needed, for clarification or issue resolution
+ Cultivates an innovation mindset, looks for ways to improve current processes with enhancements and ideas, working within the regulatory framework.
+ Assist in training process and mentoring new Provider Enrollment Coordinators and assumes a mentorship role.
+ Plans, prioritizes, organizes and completes work to meet established objectives/SLAs/Timelines.
+ Monitors trends and notifies supervisor of recurring or high priority issues.
About Walgreens
Founded in 1901, Walgreens (www.walgreens.com) has a storied heritage of caring for communities for generations and proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico, and leading omni channel platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for retail pharmacy and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
Walgreens is the flagship U.S. brand of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), an integrated healthcare, pharmacy and retail leader. Its retail locations are a critical point of access and convenience in thousands of communities, with Walgreens pharmacists playing a greater role as part of the healthcare system and patients care teams than ever before. Walgreens Specialty Pharmacy provides critical care and pharmacy services to millions of patients with rare disease states and complex, chronic conditions.
The actual salary an employee can expect to receive, plus bonus pursuant to the terms of any bonus plan if applicable, will depend on experience, seniority, geographic location, and other factors permitted by law. To review benefits, please visit jobs.walgreens.com/benefits More Company information is available at www.walgreensbootsalliance.com.
Job ID: 1657675BR
Title: Senior Specialist, HAR Provider Enrollment
Company Indicator: Walgreens
Employment Type:
Job Function: Finance/Accounting
Full Store Address: 108 WILMOT ROAD,DEERFIELD,IL 60015
Full District Office Address: 1901 E VOORHEES ST #24WAG,DANVILLE,IL,61832-04150-16365-S
External Basic Qualifications:
+ High School Diploma or GED plus at least 1 years’ experience in an office or customer service position.
+ Intermediate level keyboarding skills and basic level PC skills (at least 25 WPM, touch typing, formatting documents, using mouse, know how to navigate MS Windows, know how to print and do searches).
+ Basic level skill in Microsoft Office: Word (for example: creating documents, entering and formatting text, page layouts, creating tables, and adding graphics) and Excel (for example: creating worksheets, entering data, creating basic formulas, working with cells and rows) and Access.
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
+ Experience with professional communications. Both verbally (on the phone, one-on-one) and in writing (emails, letters) to various audiences (work group, team, company management, external agencies)
Preferred Qualifications:
+ Bachelors degree
+ Experience with applicable U.S. Healthcare regulations.
+ At least 2 years of experience working in an office.
+ Intermediate level skill in Microsoft Access (for example: opening a table in datasheet view, entering data, filtering data, creating a form, modifying a form layout, applying themes, running, sorting and saving queries, creating and formatting a report, changing report test, adding an image, printing labels, navigating through records, and/or exporting to Excel).
+ Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
+ Experience reviewing and auditing own work or others' work.
We will consider employment of qualified applicants with arrest and conviction records.
Shift:
Store:W
Walgreens
Founded over a century ago in 1901, we have a rich and colorful history of continuous improvement and innovation at Walgreens. From inventing the world’s first chocolate malted milkshake to the creation of one of the most popular and sophisticated mobile applications in retail shopping today, we have transformed ourselves into a leader within the retail and drug industry.
Walgreens, one of the nation’s largest drugstore chains, is included in the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc., the first global pharmacy-led, health well being enterprise.
At Walgreens you'll find a team positively energized by the unique talents, ideas, experiences and aspirations of every individual. In other words, you can be your authentic self in our stores, offices and other workplaces, and be comfortable and confident that what matters most here is doing your best to make health and well-being within reach for everyone on a daily basis.
Walgreens has a proud legacy of valuing diversity and fostering inclusion more than 100 years-strong, and we're still living that commitment. We intend to be recognized as a “Next Practices” company for diversity and inclusion – one whose cultures, people, perspectives and workplaces reflect the current and future customers we serve while delivering superior business performance.
Walgreens has over 9,500 stores in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
10,000 employees or more
https://www.walgreens.com/