Billing Compliance Manager - Pharmacy

Billing Compliance Manager - Pharmacy

  • Location BENTONVILLE, AR
  • Career Area Legal, Compliance and Ethics
  • Job Function Compliance
  • Employment Type Full Time
  • Position Type Salary
  • Requisition 1049568BR

What you'll do at

  • Demonstrates up-to-date expertise in health and wellness and applies this to the development, execution, and improvement of action plans
  • Manages accreditation processes for durable medical equipment products reimbursed under Medicare by: researching and communicating industry best practices in selling and dispensing durable medical equipment; implementing and updating policies and procedures related to accreditation standards; serving as primary point of contact with third-party accreditation agency; communicating accreditation standards and expectations to field associates; monitoring and responding to accreditation surveys, including identifying trends and concerns; communicating accreditation survey findings to senior leadership; recommending and implementing, with input of senior leadership, program updates based on accreditation survey results.
  • Manages implementation of Health Insurance Portability and Accountability Act (HIPAA) policy, procedure and processes
  • Manages the planning and execution of compliance investigations (for example, Health Insurance Portability and Accountability Act (HIPAA), Medicare, Medicaid, state dispensing regulations) for Walmart, Sam's Club and Puerto Rico
  • Models compliance with company policies and procedures and supports company mission, values, and standards of ethics and integrity
  • Provides and supports the implementation of business solutions
  • Provides health and wellness compliance training
  • Reports compliance concerns
  • Responds to compliance questions and monitors state and federal law and regulations

Minimum Qualifications

  • Bachelor s degree in Business, Healthcare, Compliance, or related field OR 4 years experience in healthcare, medical billing, audit, compliance, legal, or related field.

Preferred Qualifications

• 3+ years’ experience with a medical billing compliance program or related healthcare organization

• Experience working for a governing body such as Centers for Medicare & Medicaid (CMS), Office of Inspector General (OIG), Department of Justice (DOJ), etc.

• Certification in one of the following Health Care Compliance (CHC), Health Care Privacy (CHPC), Public Accountant (CPA), or Internal Auditor (CIA)

About Walmart

At Walmart, we help people save money so they can live better. This mission serves as the foundation for every decision we make, from responsible sourcing to sustainability—and everything in between. As a Walmart associate, you will play an integral role in shaping the future of retail, tech, merchandising, finance and hundreds of other industries—all while affecting the lives of millions of customers all over the world. Here, your work makes an impact every day. What are you waiting for?

Hello, NW Arkansas

With over 200 miles of trails, an emerging locally-sourced food scene, the world-renowned Crystal Bridges Museum—NWA has something for everyone.

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All the benefits you need for you and your family

  • Multiple health plan options
  • Vision & dental plans for you & dependents
  • Associate discounts in-store and online
  • Financial benefits including 401(k), stock purchase plans and more
  • Education assistance for Associate and dependents

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