Position Summary:As a Accounts Receivable Specialist, you will work in a pharmacy operation setting at our Patient Financial Service Centers, supporting the claims follow up, denial and appeals processes. You will work out of an aged work, list queue processing denials, unpaid claims and secondary billing efforts for both commercial and government payers.
You must have preciseness, excellent written and verbal customer service skills and advanced computer skills in order to interact with key stakeholders and patients as well as high level of integrity and accountability. You will ensure proper reimbursement efforts are completed to patient accounts accurately and work with payers to get any discrepancies resolved, this would involve efficiency, ingenuity and a creative mindset.
You will follow up on payment denials and underpayments on patients accounts, working with payers to ensure that all claims have been processed correctly and have been applied to the appropriate accounts. You will continually monitor the collections process to ensure that any collections effort, adjustments and write offs have been documented and recorded on patient accounts.
You will directly impact a patient's life by ensuring all payer payments have been appropriately allocated, helping to alleviate the financial burden to patients.
CVS/Specialty is a fortune 10 company. This is uniquely rewarding opportunity putting your skills and experiences to work supporting an innovative specialty pharmacy operation.
Required Qualifications:- 3 + years of advanced experience in MS Office
- 1+ years of experience in billing for Medicare, Medicaid, or other government insurances
- 2 + total years of experience in any of the following:
- billing experience in pharmacy and/or medical coding and billing- electronic and paper
- pharmacy and/or medical insurance payment posting and balancing
- pharmacy and/or medical claims and accounts receivablePreferred Qualifications:- Additional years of experience
- Previous experience or training with processing paper (HCFA 1500 and Universal Claim Forms) and /or WEBMD claims
- Previous experience with private pay and medical an/or pharmacy insurance
- Previous posting payments and reconciliation experience or training in a medical and/or pharmacy setting
- Experience using medical and/or pharmacy billing software
- Experience in medical terminology, ICD-9-CM and CPT-4 codes.
Education:Verifiable High School Diploma or GED requiredBusiness Overview:
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW
and EEO IS THE LAW SUPPLEMENT
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CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/