Medical Billing Representative

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 available for a full-time Medical Billing Representative.

As a Medical Billing Representative, you will ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers.

Key Responsibilities:

• Create and submit medical claims to insurance companies within timely filing and ensure accuracy within payer guidelines and preferred bill methods.
• Validate coverage and eligibility prior to claim billing.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Maintain supporting and chronological notes that detail action taken to resolve billing edits.
• Update information within the necessary AR/CVS systems in accordance with company policy and compliance regulations.
• Communicate effectively with patients, providers, and insurance agents to resolve account issues.
• Research information on provider portals.
• Collaborate with collections team to ensure that payer guidelines are being met.
• Spot inaccuracies or inconsistencies in medical documentation and ensure precision.

Required Qualifications:

• 1+ year of healthcare insurance experience.
• Experience using Microsoft Office products, specifically Excel, Outlook and Word.
• Must live within 1 hour of the Monroeville, PA office.

Preferred Qualifications:

• Insurance billing or collections experience.
• Customer service experience in a healthcare and team environment.
• Attention to detail.
• Ability to multitask and meet deadlines.
• Problem-solving skills.
• Professional communication skills.

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.