Pharmacy Benefits Representative

  • Company: CVS Health
  • Location: Allentown, Pennsylvania
  • Posted: October 26, 2017
  • Reference ID: 711852BR
Position Summary:

Omnicare,Inc. is a wholly owned subsidiary of CVS Health corporation.

What We Do

Directly, and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the healthcare environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

Monday-Friday: 8:30am-5:00pm


This position is responsible for gathering and entering information related to the payer status of patients from the facility, or from the responsible party.

In this role you will

  • Ensure that census paperwork is received from the Nursing facility.
  • Ensure that the census is entered into the operating system accurately and is valid coverage.
  • Review paperwork and verify completeness and of intake process focusing on payer verification and selection.
  • Ensure effective coordination and communication between the local pharmacy and the Central Billing Center.
  • Ensure the smooth dissemination of information relative to Revenue Management to the pharmacy/site and Omnicare customers.
  • Work Medicaid Pending reports from i-Astral and the operating system to ensure timely application of Medicaid coverage. Improve account identification on Medicaid Application Pending (MAP).
  • Participate in training session or conference calls to further C2W ADT management knowledge.
  • C2W ADT Workflow grid is cleared daily for all assigned facilities.
  • Work and partner with other internal departments to resolve issues.
  • Follow all applicable government regulations including HIPAA.
  • Participate in projects and/or meeting as designated by management.
  • Other duties as assigned; job duties may vary by location.

Required Qualifications:
You will need

  • A high school diploma or its equivalent
  • Basic knowledge of insurance procedures
  • Ability to work in a fast paced, rapidly changing environment.
  • Excellent verbal and written communication as well as listening skills.
  • Intermediate computer and typing skills.

Preferred Qualifications:
You have
  • 6-12 months of long term care pharmacy billing experience.
  • Minimum of 1-3 years of experience working in an office/business setting.
  • Healthcare industry experience.
  • Prescription third party claims management experience.

  • High School Diploma or equivalent

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 EEO AA CVS Health

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:

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