Experienced Medicare Billing Collections Specialist - Insurance Billing and Reimbursement Expertise

Transforming Healthcare through Exceptional Billing and Collections Expertise

At CVS Health, we're on a mission to bring our heart to every moment of your health. As a leading healthcare organization, we're committed to delivering enhanced human-centric health care that's more personal, convenient, and affordable. Our Specialty Pharmacy in Monroeville, PA, is seeking an experienced Medicare Billing Collections Specialist to join our team and drive success in our insurance billing and reimbursement processes.

About Us

CVS Health is a renowned healthcare company that's dedicated to making a positive impact on people's lives. Our culture is built around our core purpose: Bringing our heart to every moment of your health. We strive to create a work environment that's collaborative, innovative, and supportive, where our employees can grow and thrive. As a Medicare Billing Collections Specialist, you'll be part of a dynamic team that's passionate about delivering exceptional patient care and outstanding customer service.

Job Summary

We're looking for a skilled Medicare Billing Collections Specialist to handle timely billing and insurance follow-up for our Specialty Pharmacy in Monroeville, PA. As an Insurance Billing/Collections Representative, you'll be responsible for ensuring accurate account payment for outstanding balances while providing excellent customer service to patients, healthcare professionals, and insurance carriers. If you have a strong background in insurance billing and collections, and a passion for delivering exceptional results, we encourage you to apply for this exciting opportunity.

Key Responsibilities

• Respond to Medicare audits and appeals in a timely and effective manner
• Research and gather documentation to support all levels of appeals for Medicare
• Conduct third-party follow-up associated with the dispensing of prescription medication via telephone, internet, and in writing
• Resolve issues with nonpayment of invoices due to insurance problems, incorrect or incomplete information, therapy changes, and pharmacy or shipping errors
• Maintain supporting chronological notes that detail actions taken to resolve outstanding account balances
• Update patient demographic information and data collection systems
• Research and respond to insurance companies and governmental payers regarding collection issues and problems via telephone, internet, and in writing
• Contact patients, physician's offices, and insurance companies as needed to expedite claims processing

Essential Qualifications

To succeed in this role, you'll need:

• 6 months or more of related work experience in insurance billing or collections
• Experience using Microsoft Office products, specifically Excel, Outlook, and Word
• A high school diploma or GED
• Ability to live within a 1-hour commute from the Monroeville, PA office

Preferred Qualifications

While not required, the following qualifications can give you a competitive edge:

• Insurance billing or collections experience
• Working knowledge of problem-solving and decision-making skills
• Experience working in a healthcare reimbursement system
• Effective customer service skills and experience working in a team environment
• Attention to detail and ability to utilize analytical skills
• Certified Billing and Coding Specialist (CBCS) certification

Skills and Competencies

To excel in this role, you'll need:

• Strong analytical and problem-solving skills
• Excellent communication and customer service skills
• Ability to navigate multiple tasks simultaneously and prioritize based on importance
• Strong attention to detail and organizational skills
• Proficiency in Microsoft Office products, specifically Excel, Outlook, and Word

Career Growth Opportunities and Learning Benefits

At CVS Health, we're committed to helping our employees grow and develop their skills. As a Medicare Billing Collections Specialist, you'll have access to:

• Comprehensive training programs to enhance your skills and knowledge
• Opportunities for career advancement and professional growth
• A collaborative and supportive work environment that encourages innovation and teamwork

Work Environment and Company Culture

Our Specialty Pharmacy in Monroeville, PA, offers a state-of-the-art and comfortable workspace. As an employee, you'll enjoy:

• A remote office with flexible work arrangements
• Free parking and convenient location
• A collaborative and dynamic work environment that values diversity and inclusion
• Access to a range of employee benefits and wellness programs

Compensation and Benefits

We offer a competitive salary and benefits package that includes:

• A pay range of $17.00 - $28.46 per hour, depending on experience and qualifications
• Eligibility for a CVS Health bonus, commission, or short-term incentive program
• A comprehensive benefits package, including medical, dental, and vision coverage
• A 401(k) retirement savings plan and Employee Stock Purchase Plan
• Paid time off, holidays, and sick leave
• Access to employee discounts and wellness programs

Join Our Team

If you're a motivated and experienced Medicare Billing Collections Specialist looking for a new challenge, we encourage you to apply for this exciting opportunity. At CVS Health, we're committed to making a positive impact on people's lives, and we're looking for talented individuals to join our team. Apply now and take the first step towards a rewarding career with a leading healthcare organization.

Ready to Apply?

If you're reliable, willing to learn, and passionate about delivering exceptional results, we want to hear from you. Apply now and join our team of dedicated professionals who are shaping the future of healthcare.