Pharmacy Reimbursement Representative - Monroeville, PA (Hybrid)

Bring your heart to CVS Health. Every 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.

Position Summary

This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices.

Role Overview

• Schedule : Monday-Friday 8 : 00AM-4 : 30PM EST (Flex Start after training)
• Hybrid Role
• Training : 2-3 weeks of training

What you will do

• Qualifying, preparing and submitting claims to Copay Assistance program.
• Work with pharmacy operations staff, prescriber offices, third party payers, patients and / or their responsible parties and claim processors.
• Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution.
• Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.

Required Qualifications

• Minimum 1 year experience performing healthcare reimbursement, medical insurance / billing or related work.
• Customer service skills with the ability to work in a team environment.
• Experience in MS Word, Excel and Outlook.
• Must live within a 1 hour commute of the Monroeville, PA office.

Preferred Qualifications

• Ability to prioritize daily tasks.
• Working knowledge of medical terminology.
• Experience working with healthcare reimbursement systems.
• Working knowledge of problem solving and decision making skills
• Certified Billing and Coding Specialist (CBCS) preferred.

Education

High School Diploma

Pay Range

The typical pay range for this role is :

$17.00 - $28.45

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.