CVS Health, Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full-time billing/collections representative. The Pharmacy Billing/Collections Representative will ensure timely and accurate billing for unbilled claims and ensure account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers.
Key Responsibilities of the Pharmacy Billing Representative:
• Third Party insurance claim billing and follow up associated with the dispensing of prescription medication using the bill method required by the payer.
• Transmit or submit claims (paper, electronic) to insurance payers for reimbursement.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Maintain supporting chronological notes that detail actions taken to resolve outstanding unbilled claims.
• Maintain patient demographic information in data collections systems.
• Work all billing reports and queues while remaining in accordance with payer and company policy guidelines.
• Research and respond by telephone, via the internet and in writing to patients, physician's offices, insurance companies and governmental payers regarding billing issues and problems as well to expedite claims processing.
1+ year(s) experience performing healthcare reimbursement, medical insurance billing or related work.
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
• Customer service in healthcare environment.
• Experience working with a healthcare reimbursement system preferred.
• Ability to communicate with clientele in a professional manner; both verbally and written.
• Attention to detail.
• Ability to utilize analytical skills.
• Effective customer service skills and experience that shows ability to work in a team environment.
• Experience in MS Office, specifically Excel, Outlook, and Word
Verifiable High School Diploma or GED required.
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.