What are the responsibilities and job description for the (USA) Manager II, Billing position at Walmart?
Position Summary...
What you'll do...
Ensures compliance with laws and regulations by
Develops and drives the implementation of strategies to support industry and company initiatives by
Manages and maintains vendor contracts by
Serves as subject matter expert by
Manages customer service and vendor call centers by
Coordinates, completes, and oversees job-related activities and assignments by
Provides supervision and development opportunities for associates by
hiring and training
Ensures compliance with company policies and procedures and supports company mission, values, and standards of ethics and integrity by
#LI-MF4
Live our Values
Culture Champion
Servant Leadership
Embrace Change
Curiosity & Courage
Digital Transformation & Change
Deliver for the Customer
Customer Focus
Strategic Thinking
Focus on our Associates
Diversity, Equity & Inclusion
Collaboration & Influence
Talent Management
Minimum Qualifications...
Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications.
As permitted by applicable law, provide evidence of full vaccination as defined by CDC guidelines OR secure approval of medical or religious accommodation for the vaccination mandate., Minimum Qualifications: Bachelor's degree in Business Management, Accounting, Project Management, Healthcare Management, or related field and 2 years' experience in insurance claims, accounting, or related area OR 4 years' experience in insurance claims, accounting, or related area
Preferred Qualifications...
Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.
Masters: Business Administration
Primary Location...
2608 Se J St, BENTONVILLE, AR 72712, United States of America
What you'll do...
Ensures compliance with laws and regulations by
- researching changes to federal, state, and local laws and regulations impacting insurance payment of medical bills
- ensuring changes in state reporting requirements, periodic fee schedules, and applicable laws and regulations are applied to bill review process and procedures
- evaluating auditing results to ensure the audit forms measure the desired quality results
- modifying the auditing process as regulatory agency requirements change
- building and maintaining relationships with other bill processing teams, state agencies, the Legal department, and bill review suppliers to clarify regulations or implement systematic changes required for compliance
- evaluating vendor processors quality audit results, providing feedback on results to vendor processors, and creating action plans to correct deficiencies
- ensuring regulatory certifications for state and federal utilization and bill review are obtained.
Develops and drives the implementation of strategies to support industry and company initiatives by
- collaborating with federal and state governments and commercial programs to further common long-term goals
- determining impact of proposed billing programs on Walmart and the industry
- providing guidance on current systems and operations
- providing solutions or alternatives to proposed programs
- representing Walmart at national and state conferences and workgroups.
Manages and maintains vendor contracts by
- holding vendors accountable for delivering contracted services
- ensuring contract language meets business and compliance requirements
- monitoring workflow and changing it to meet vendor requirements to obtain discounted services
- ensuring claims team complies with contract requirements.
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 counsel
- 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 developing explanation of review statements for multiple states
- educating team and vendor processors on pre-litigation best practices
- participating and leading special projects to enhance bill payment processes.
Manages customer service and vendor call centers by
- reviewing reports on call time averages to make sure calls are processed efficiently and effectively
- ensuring responses to inquiries regarding pharmacy and medical billing from internal and external stakeholders
- identifying and resolving global trends on escalated issues (for example, unprocessed hospital bill complaints).
Coordinates, completes, and oversees job-related activities and assignments by
- developing and maintaining relationships with key stakeholders
- supporting plans and initiatives to meet customer and business needs
- identifying and communicating goals and objectives
- building accountability for and measuring progress in achieving results
- identifying and addressing improvement opportunities
- demonstrating adaptability and promoting continuous learning.
Provides supervision and development opportunities for associates by
hiring and training
- mentoring
- assigning duties
- providing recognition
- ensuring diversity awareness.
Ensures compliance with company policies and procedures and supports company mission, values, and standards of ethics and integrity by
- implementing related action plans
- utilizing and supporting the Open Door Policy
- providing direction and guidance on applying these in executing business processes and practices.
#LI-MF4
Live our Values
Culture Champion
- Models the Walmart values to foster our culture; holds oneself and others accountable; and supports Walmart's commitment to communities, social justice, corporate social responsibility, and sustainability; maintains and promotes the highest standards of integrity, ethics and compliance.
Servant Leadership
- Acts as an altruistic servant leader and is consistently humble, self-aware, honest, and transparent.
Embrace Change
Curiosity & Courage
- Demonstrates curiosity and a growth mindset; fosters an environment that supports learning, innovation, and intelligent risk-taking; and exhibits resilience in the face of setbacks.
Digital Transformation & Change
- Seeks and implements continuous improvements and encourages the team to leverage new digital tools and ways of working.
Deliver for the Customer
Customer Focus
- Delivers expected business results while putting the customer first and consistently applying an omni-merchant mindset and the EDLP and EDLC business models to all plans.
Strategic Thinking
- Adopts a holistic perspective that considers data, analytics, customer insights, and different parts of the business when making plans and shaping the team's strategy.
Focus on our Associates
Diversity, Equity & Inclusion
- Identifies, attracts, and retains diverse and inclusive team members; builds a high-performing team; embraces diversity in all its forms; and actively supports diversity goal programs.
Collaboration & Influence
- Builds strong and trusting relationships with team members and business partners; works collaboratively and cross-functionally to achieve objectives; and communicates with energy and positivity to motivate, influence, and inspire commitment and action.
Talent Management
- Creates a discipline and focus around developing talent, promotes an environment allowing everyone to bring their best selves to work, empowers associates and partners to act in the best interest of the customer and company, and regularly recognizes others' contributions and accomplishments.
Minimum Qualifications...
Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications.
As permitted by applicable law, provide evidence of full vaccination as defined by CDC guidelines OR secure approval of medical or religious accommodation for the vaccination mandate., Minimum Qualifications: Bachelor's degree in Business Management, Accounting, Project Management, Healthcare Management, or related field and 2 years' experience in insurance claims, accounting, or related area OR 4 years' experience in insurance claims, accounting, or related area
Preferred Qualifications...
Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.
Masters: Business Administration
Primary Location...
2608 Se J St, BENTONVILLE, AR 72712, United States of America
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