CVS Health is an American healthcare company working across healthcare services, health insurance, pharmacy benefits management, and retail pharmacy. Through businesses including Aetna and CVS Caremark, it supports health coverage, prescription access, condition management, specialty medications, and mail-order pharmacy services. Its neighborhood pharmacies and broader care offerings are designed to help people access essential healthcare more conveniently and affordably. CVS Health brings together insurance, pharmacy, and health services to support individuals and communities throughout their care journeys.
Medical Billing Coordinator, Revenue Cycle — CVS Health
Process insurance claims for CVS Health Specialty Pharmacy and help resolve billing issues to support reimbursement. This hybrid role is based in Monroeville, Pennsylvania.
Description
- Bill third-party payers for dispensed medications using each payer’s required method.
- Submit electronic and paper claims to insurers for reimbursement.
- Resolve insurance and patient billing issues caused by missing or incorrect information, therapy changes, or pharmacy and shipping errors.
- Keep chronological notes of actions taken to resolve billing edits.
- Maintain patient demographic and insurance records, along with billing reports, queues, and diversions, in line with payer and company policies.
- Research and respond to billing questions from insurers and government payers by phone, online, and in writing.
- Contact patients, physician offices, or insurers as needed to move claims forward.
- Deliver accurate, timely billing and customer service to patients, healthcare professionals, and insurers.
- Contribute to the billing and reimbursement team in a fast-paced, collaborative environment.
Requirements
- At least one year of healthcare insurance billing experience.
- Experience with Microsoft Office, especially Excel, Outlook, and Word.
- Ability to commute to the Monroeville, Pennsylvania office.
- Experience in insurance billing or collections.
- Healthcare customer service experience.
- Experience using a healthcare reimbursement system.
- Strong customer service skills and the ability to work well on a team.
- Careful attention to detail.
- Ability to apply analytical skills.
- Professional verbal and written communication skills with clients.
- Verifiable high school diploma or GED.
Benefits
- Free parking.
- CVS Health bonus, commission, or short-term incentive program in addition to base pay.
- Medical coverage.
- Dental coverage.
- Vision coverage.
- Paid time off.
- Retirement savings options.
- Wellness programs.
- Additional resources for physical, emotional, and financial well-being, subject to eligibility.