As a Medical Billing Specialist, you will be responsible for completing Patient Financial Services (PFS) tasks such as billing and/or accounts receivable follow-up with payers and maintaining quality and productivity requirements as outlined in the position performance expectations. You will process and submit accurate and timely claims to payers,analyze and research unpaid claims, and assist in the resolution of denials,partial payments, and payment variances.
Additional responsibilities of the Senior Medical Billing Specialistinclude:
- Maintain and release all-ship-verified claims for all third party claim (commercial or government) accounts within established time frame as assigned
- Resolve errors and make claim edits assigned in work queues
- Follow work list prioritization of accounts as established by department policies and procedures for resolving accounts and/or submitting claims Contact payers and patients when necessary for PFS processes
- Request relevant information from appropriate Revenue Cycle and clinical departments as required through the course of the PFS processes
- Make necessary adjustments to patient demographic, insurance, and account balance information
- Complete A/R adjustments where permitted and appropriate; request other adjustments where permitted and appropriate
- Comply with and adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements), and "leading practices"
2 + years of medical billing experiencePreferred Qualifications
- 6 months of healthcare Revenue Cycle experience, preferably within Billing
- Knowledge of healthcare billing, collections practices, and/or infusion services
- Exceptional communication, customer service skills, and phone etiquette
- Familiarity with customer service expectations, computer processing, and medical and billing office terminology
- Strong leadership and multitasking skills
- Strong communication both over the phone and email
High school diploma/GED required.
Coram CVS/specialty infusion services is a leading national provider of specialty home infusion and specialty pharmacy services. The integration of Coram into CVS Health enables the company to offer enhanced, comprehensive infusion services; expanded payer access; and a national network of more than 85 locations, including 65 ambulatory infusion suites. Providing infusion therapies and services to over 20,000 patients each month, Coram cares for patients through all phases of their healthcare continuum including clinical and compliance monitoring, and individual patient counseling. CVS Health, through our unmatched breadth of service offerings, is the nation’s largest pharmacy health care provider transforming the delivery of health care services in the U.S. Our energetic and service-oriented colleagues embrace fresh ideas, new perspectives, a diversity of experiences, and a dedication to service to meet the needs of the many people and businesses relying on us each day.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW
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