Job Description Analyze patient account detail (charges, payments, adjustments) and answer detailed questions from patients and payers regarding claims or account status. Manage and maintain AR for billing and collection. Monitor claims monthly to ensure proper payment is received as needed. Run reports to monitor unpaid claims and adheres to ACS collection procedures and protocol. Process Pharmacy NCPDP, paper and WEBMD claims as needed. Reviews all no payment responses received and forwards any claims needing corrections to be reprocessed. Participate in all billing and collection related meetings and training as requested by the Billing Manager.
Required Qualifications - 1+ years of MS Office experience
- 1+ total years of experience in any of the below:
- Billing experience in pharmacy and/or medical coding and billing.
- Payment posting and balancing.
- Medical Claims.
Preferred Qualifications- Reimbursement experience with Insurance payers (MCD, MCR, Commercial, Part D and Supplemental plans)
- Experience using medical /pharmacy billing software.
- Experience in medical terminology, ICD-9-CM and CPT-4 codes
- Experience working with Medicare and Medicaid, DMERC Oral Anti-Cancer Policy.
- Experience using Microsoft Word and Excel.
- Experience using CPR Plus. Education- Verifiable High School Diploma or GED required Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
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
and EEO IS THE LAW SUPPLEMENT
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/