Pharmacy Claims Biller, Revenue Cycle

CVS Health • Monroeville, PA

1d • $17 - $28 • Onsite

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 available for a full time Pharmacy Claims Biller. As a Biller, you will ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of the billing and reimbursement team, you will work in a fast paced and team focused environment to ensure timely and accurate billing to insurance providers. Located in the Monroeville Facility, this opportunity also provides free parking. We will support you by offering all the tools and resources you need to be successful in a collaborative team-based environment. What you will do Third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer. Transmit or submit claims (paper/electronic) to insurance payors and other third parties for reimbursement. Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information and therapy changes. Maintain supporting and chronological notes that detail action taken to resolve billing edits. Maintain patient demographic and insurance information and data collections systems, including all billing reports, work queues, or diversions according to payer and company policy guidelines. Research and respond to insurance companies and governmental payors regarding billing issues or related questions by telephone, via the internet, and in writing. Contact patients, physician's offices or insurance carriers as needed in order to expedite billing claims.

Requirements

• 1 year of Healthcare Insurance Billing or related experience.
• Customer service skills with the ability to work in a team environment.
• Experience using Microsoft Office products specifically Excel, Outlook and Word.
• Must live within a 1-hour commute from the Monroeville, PA office.

Nice To Haves

• Insurance billing or collections experience.
• Ability to prioritize daily tasks.
• 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.
• Working knowledge of medical terminology.
• Attention to detail.
• Effective problem solving and decision-making skills.
• Ability to communicate with clientele in a professional manner; both verbally and written.

Responsibilities

• Third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer.
• Transmit or submit claims (paper/electronic) to insurance payors and other third parties for reimbursement.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information and therapy changes.
• Maintain supporting and chronological notes that detail action taken to resolve billing edits.
• Maintain patient demographic and insurance information and data collections systems, including all billing reports, work queues, or diversions according to payer and company policy guidelines.
• Research and respond to insurance companies and governmental payors regarding billing issues or related questions by telephone, via the internet, and in writing.
• Contact patients, physician's offices or insurance carriers as needed in order to expedite billing claims.

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