Representative, Suspended Billing Coram
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 As a Biller, you play an integral role in delivering cost effective solutions for our patients by providing timely and accurate billing of claims to insurance companies for healthcare reimbursement. In this role you will perform follow-up on outstanding prescriptions using suspended billing reports; maintain and monitor follow up systems to confirm action takes place, contacting patients as needed; evaluate completed prescriptions ensuring information is obtained allowing for reimbursement and compliance; perform internal quality audits to ensure proper documentation; request account adjustments; ensure claims are accurately priced, placed on appropriate hold status, resolve payer rejected claims, and maintain quality and productivity requirements. To be successful in this role you will utilize Excel, Outlook, and Word; your attention to detail, strong data entry skills and customer service mindset. 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 8:30am ending your day by 5:00pm.
Requirements
- 1+ years of experience in a professional environment
- beginner level experience working in Excel, Outlook, and Word
- Verifiable High School Diploma or GED required
Nice To Haves
- Knowledge of healthcare billing and terminology, collections practices, and/or infusion services, and data entry accuracy
Responsibilities
- perform follow-up on outstanding prescriptions using suspended billing reports
- maintain and monitor follow up systems to confirm action takes place, contacting patients as needed
- evaluate completed prescriptions ensuring information is obtained allowing for reimbursement and compliance
- perform internal quality audits to ensure proper documentation
- request account adjustments
- ensure claims are accurately priced, placed on appropriate hold status, resolve payer rejected claims, and maintain quality and productivity requirements
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, starting your 8-hour day between 6:00am and 8:30am ending your day by 5:00pm
- 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
