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

CVS Health • Bethel Park, PA

3d • $17 - $28 • Hybrid

About The Position

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Medical Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up. The Medical Benefit Credit and Refund Specialist Coordinator will ensure timely and accurate credit balance resolution with third party payers while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of this team, you will work in a fast paced and team focused environment. We will support you by offering all the tools and resources you need to be successful in a collaborative team environment. Located in the Monroeville facility, this opportunity also provides free parking.

Requirements

• 1+ years of Healthcare Insurance related experience.
• Experience using Microsoft Office products’ specifically Excel, Outlook, and Word.
• Must be able to commute to the Monroeville, PA office.

Nice To Haves

• Medical insurance billing or collections experience.
• Customer service in a healthcare environment.
• Experience working in a healthcare reimbursement system.
• Effective customer service skills and experience that shows ability to work in a team environment.
• Attention to detail.
• Ability to utilize analytical skills.
• Ability to navigate through multiple tasks simultaneously and prioritize based on importance while displaying strong attention to detail.
• Ability to communicate with clientele in a professional manner; both verbally and written.

Responsibilities

• Third party insurance follow-up associated with the dispensing of prescription medication via telephone, Internet, and in writing.
• Review and validate the credit balance by verifying accurate billing and cash posting procedures.
• Resolve issues related to credit balances including identifying overpayments and validating appropriate revenue recognition.
• Perform analytical activities for the revenue cycle department managing healthcare accounts receivable.
• Initiate refunds, reverse claims, request payer offsets, and post adjustment transactions.
• Maintain supporting chronological notes that detail action taken to resolve outstanding account balances.
• Maintain patient demographic information and data collection systems
• Research and respond by telephone, via the internet and in writing to insurance companies and governmental payers regarding collection issues and problems.
• Contact patients and Physician’s offices as well as insurance companies as needed in order to validate claims processing and payments.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees