Pharmacy Benefit Credit and Refund Specialist Coordinator, Revenue Cycle (Hybrid)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

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. The Pharmacy Benefit Credit and Refund Specialist Coordinator will ensure timely and accurate credit balance resolution with payers while demonstrating excellent customer service to patients, healthcare professionals, and insurance carriers.  As part of this team, you will work in a fast paced and team focused environment.

We will support you by offering all the tools and resources you need to be successful in a collaborative team environment.

• →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.

• 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.

• 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 utilize analytical skills.
• Ability to navigate through multiple tasks simultaneously and prioritize based on importance while displaying strong attention to detail.
• Ability to communicate with clientele in a professional manner; both verbally and written.

• Verifiable High School Diploma or GED required.

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.