Medical Benefit Credit & Refund Coordinator - Monroeville, PA (Hybrid)
About The Position
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. 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.
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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
