Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Pharmacy Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up.
Key Responsibilities:
- Third-party insurance follow-up associated with the dispensing of prescription medication via telephone, Internet, and in writing.
- Review and validate the credit balance by verifying accurate billing and cash posting procedures.
- Resolve issues related to credit balances, including identifying overpayments and validating appropriate revenue recognition.
- Perform analytical activities for the revenue cycle department managing healthcare accounts receivable.
- Initiate refunds, reverse claims, request payer offsets, and post adjustment transactions.
- Maintain supporting chronological notes that detail action taken to resolve outstanding account balances.
- Maintain patient demographic information and data collection systems.
- Research and respond by telephone, via the internet and in writing to insurance companies and governmental payers regarding collection issues and problems.
- Contact patients and Physician's offices as well as insurance companies as needed in order to validate claims processing and payments.
Required Qualifications:
- 1+ years of Healthcare Insurance related experience.
- Experience using Microsoft Office products, specifically Excel, Outlook, and Word.
- Must be able to commute to the Monroeville, PA office.
Preferred Qualifications:
- Insurance billing or collections experience.
- 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.
- Attention to detail.
- Ability to utilise analytical skills.
- Ability to navigate through multiple tasks simultaneously and prioritise based on importance while displaying strong attention to detail.
- Ability to communicate with clientele in a professional manner; both verbally and written.
Education:
- Verifiable High School Diploma or GED required.
Anticipated Weekly Hours: 40
Time Type: Full-time
Pay Range: $17.00 - $28.46
Benefits: This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.