Medical Reimbursement Representative

CVS Health

11d • $17 - $28

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 As a Collector, you play an integral role in delivering cost effective solutions for our patients by working with insurance companies to resolve issues associated with our patients’ insurance claims. In this role you will ensure timely follow-up on all patient accounts; including escalating payer trending concerns to leadership and timely communication with external departments; work with payers to ensure proper reimbursement on patient accounts, identify and prepare adjustments and write-offs; correct and resubmit claims (subject to policy); follow-up on daily correspondence (denials, short-pays); interface with insurance companies via phone and web portal to check claim status, submit written correspondence to payers and patients; interpret contracts with payers to ensure proper payment; send initial or secondary bills to insurance companies; process refunds and work to overturn insurance claim rejections while maintaining quality and productivity requirements. To be successful in this role you will utilize Excel, Outlook, and Word and your critical thinking skills to ensure a high quality of work. We offer instructor led training programs to set you up for success, in addition to a comprehensive benefits package that begins the first of the month after your start date and includes medical, dental and vision insurance as well as supplemental benefits, retail discounts and paid time off. Additionally, we offer a flexible work schedule, starting your 8-hour day between 6:00am and 9:30am ending your day by 6:00pm. some locations require a 7:00am start time

Requirements

• 1+ years of experience in a professional environment
• 1+ years experience working in Excel, Outlook, and Word

Nice To Haves

• Home infusion or durable medical equipment (DME) experience
• Strong attention to detail with a sense of urgency
• Customer service skills
• Ability to work in a team environment
• Experience with medical billing or collections or experience with accounts payable (AP) or accounts receivable (AR)
• Experience with healthcare reimbursement systems

Responsibilities

• Ensure timely follow-up on all patient accounts; including escalating payer trending concerns to leadership and timely communication with external departments
• Work with payers to ensure proper reimbursement on patient accounts
• Identify and prepare adjustments and write-offs
• Correct and resubmit claims (subject to policy)
• Follow-up on daily correspondence (denials, short-pays)
• Interface with insurance companies via phone and web portal to check claim status, submit written correspondence to payers and patients
• Interpret contracts with payers to ensure proper payment
• Send initial or secondary bills to insurance companies
• Process refunds and work to overturn insurance claim rejections while maintaining quality and productivity requirements
• Utilize Excel, Outlook, and Word and your critical thinking skills to ensure a high quality of work

Benefits

• comprehensive benefits package that begins the first of the month after your start date and includes medical, dental and vision insurance as well as supplemental benefits, retail discounts and paid time off
• flexible work schedule
• 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