Billing and Insurance Representative.
CVS Pharmacy - Monroeville, PA
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Job DescriptionCVS Health, Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time billing/insurance follow up representative. The primary responsibilities of a Medical Collections Specialist are to ensure timely and accurate account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. Responsible for all third party follow-up associated with the dispensing of prescription medication; maintain supporting chronological notes that detail action taken to resolve outstanding account balances. Maintains patient demographic information and data collection systems. Work all billing/collection reports, queues, or diversions according to payer and company policy guidelines. Researches and responds by telephone, via the Internet and in writing to insurance companies and governmental payors regarding billing issues and problems. Follows up on submitted claims; monitors unpaid claims, initiates appeals and resubmits claims as necessary. Easily identifies payor trends, prepares projects for escalations and all other duties as assigned to ensure timely and accurate reimbursement. -Transmit or submit claims (paper, electronic) to insurance payors for reimbursement -Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors -Provide detailed follow up with patients and payors in the form of, but not limited to phone calls, fax transmittals and e-mails -Contact patients and Physician's offices as needed in order to expedite claims processing -Obtain accurate demographic, insurance and financial information from patients to ensure all account information is accurate -Located in the Monroeville Facility, this opportunity also provides free parkingRequired Qualifications- 1 + years' experience performing health care reimbursement, medical billing or insurance collections - 1+ years' experience in Microsoft Office, specifically Excel, Outlook and WordCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications-1+ years of experience with collections associated with Medical billing or collections in health care - Customer Service in a health care environment and with healthcare reimbursement - Ability to communicate with clientele in a professional manner; both written and verbal - Proven effective customer service skills and experience that shows ability to work independently and in a team environment- Ability to navigate through multiple tasks simultaneously and prioritize based on importance while displaying strong attention to detailEducationVerifiable High School Diploma or GED requiredBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Created: 2024-09-07