Medical Benefit Credit & Refund Coordinator - Monroeville, PA (Hybrid)

CVS Health • Wexford, PA

12d • $17 - $28 • Hybrid

About The Position

CVS Health Specialty Pharmacy is hiring a full-time Medical Benefit Credit and Refund Specialist Coordinator for its Monroeville, Pennsylvania facility. The role handles insurance credit balance follow-up and ensures timely, accurate resolution with third-party payers while providing customer service to patients, healthcare professionals, and insurance carriers. The position works in a fast-paced, team-focused environment and is hybrid. The Monroeville facility offers free parking.

Requirements

• At least 1 year of healthcare insurance-related experience.
• Experience using Microsoft Office products, specifically Excel, Outlook, and Word.
• Ability to commute to the Monroeville, PA office.
• Verifiable high school diploma or GED.
• Professional verbal and written communication skills.
• Ability to manage multiple tasks and prioritize according to importance, with strong attention to detail.

Nice To Haves

• Medical insurance billing or collections experience.
• Customer service experience in a healthcare environment.
• Experience working in a healthcare reimbursement system.
• Effective customer service skills and demonstrated ability to work in a team environment.
• Attention to detail.
• Ability to use analytical skills.
• Ability to navigate multiple tasks and prioritize while maintaining strong attention to detail.

Responsibilities

• Conduct third-party insurance follow-up related to prescription dispensing by telephone, internet, and in writing.
• Review and validate credit balances by verifying accurate billing and cash-posting procedures.
• Resolve credit-balance issues, including identifying overpayments and validating appropriate revenue recognition.
• Perform analytical activities for the revenue cycle department and manage healthcare accounts receivable.
• Initiate refunds, reverse claims, request payer offsets, and post adjustment transactions.
• Maintain chronological supporting notes detailing actions taken to resolve outstanding account balances.
• Maintain patient demographic information and data collection systems.
• Research and respond to insurance companies and governmental payers about collection issues by telephone, internet, and in writing.
• Contact patients, physician offices, and insurance companies as needed to validate claims processing and payments.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting physical, emotional, and financial well-being, based on eligibility
• Eligible for a CVS Health bonus, commission, or short-term incentive program
• Free parking at the Monroeville facility

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED