Pharmacy Benefit Credit and Refund Specialist Coordinator, Revenue Cycle (Hybrid)

CVS Health•Monroeville, PA

1d•Hybrid

About The Position

CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Pharmacy Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up. The Pharmacy Benefit Credit and Refund Specialist Coordinator will ensure timely and accurate credit balance resolution with 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.

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.
Verifiable High School Diploma or GED required.

Nice To Haves

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.