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Coordinator, Exceptions Management

Position Summary:
Under the direction of the Client Services Manager, the Exception Management Coordinator (EMC) works directly with the client to manage the past due balances of the client’s third-party prescription receivables.  The EMC performs detailed analysis to identify collection opportunities and is responsible for pursuing those opportunities by contacting Pharmacy Benefit Managers (PBM’s), industry payers and other third-party processors on behalf of clients in order to meet contractual agreements.

Duties also include assisting with on-boarding of new clients, cross-training with other team members, developing and improving operating processes, monitoring system processes, recommending product enhancements and system testing.   

Major Responsibilities/Essential Functions:

Performing detailed analysis on open receivables and contacting PBM’s, industry payers and other third-party processors to pursue collection opportunities for assigned accounts.

Management of payment exceptions is key to ensure delivery of service to customers per contractual obligations.

(30%)


* Researching and resolving unapplied cash related to open claims


* Performing open claims-to-cash comparisons for trending and routine clean-up recommendations


* Contacting industry players via phone and e-mail to facilitate action, developing follow-up strategy and documenting activity/results for clients


* Utilizing Pharmacy Financial Management (PFM) to aid in analysis and tracking collection results


* Developing additional tracking methods to report analysis results in multiple formats and business case scenarios


* Meeting client service level agreements related to collection practices and write-off percentages

Presenting results of analyses to clients, account managers, client services managers  and others, as defined by client need.

(25%)


* Facilitating conference calls and/or face-to-face meetings with clients


* Creating detailed spreadsheets or charts to present trending results


* Making recommendations to clients for business rules based on professional judgment and accounting practices


* Identifying opportunities for improvement to client pharmacy operations to minimize uncollectible balances

Identifying and implementing operational efficiencies in daily tasks performed by the EMC.

(10%)


* Developing analysis methods to quickly identify collection opportunities and maximize results


* Developing best practices/standard reporting for client and internal communication


* Identifying system enhancements and working with IT/Product to define, implement and test enhancements


* Presenting cost/time savings estimates and final results

Responsible for client on-boarding tasks.

(10%)


* Reviewing exceptions management service by discussing Inmar and client’s responsibilities


* Reviewing details of exceptions management process/methodology


* Recommending guidelines and best p...




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