The overall objective of this position is to assist the Retrospective Hospice Recoupment business unit in bringing Clients and Hospice Providers questions to a quick and accurate resolution. Responsibilities include, but are not limited to, maintaining the Hospice Recoupment database, producing reports as required/scheduled, reviewing and communicating Medicare Part D coverage determination status. The candidate will also be responsible for researching and responding to high visibility client inquiries and internal reporting to the different support teams. Responsibilities also include monitoring of the team general email box, and providing guidance and assistance as needed including issuance of refunds, sending determination letters, and general inquiries. The candidate will assist with regular quality reviews and assessments, and will make recommendations for process improvements. In addition, the candidate may be assigned to special projects as needed.Required Qualifications:
- 2+ years of MS Excel or MS Access experience, preferably with experience creating spreadsheets and writing queriesPreferred Qualifications:
- Prior business experience.
- Analytical skills.
- Well organized and able to work successfully under pressure handling high work volume as needed.
- Ability to pay close attention to detail.
- Ability to be able to work successfully in a highly regulated environment.
- Strong customer service and problem-solving skills.
- Excellent communication and interpersonal skills.
- Capability of working well in a team setting and well as an individual contributor.
- Ability to be able to respond in a positive, proactive, and timely manner regarding payment dispute inquiries.
- Demonstrated ability to problem solve moderate issues.
- Ability to research in multiple systems and communicate well.
- Preventive thinking and root cause analysis are critical measures of success for this position.
- Experience in analysis of financial data including reconciliations.
- Experience in data mining/manipulation.
- Experience in PBM, Medicare D, and or finance accounting experience.
- Knowledge and/or experience with PBM operating systems are desirable. Education:
Bachelor's degree in business or related field strongly desired. Verifiable High School Diploma or GED required. Business 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
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health
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/