Medical Reimbursement Representative

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

As a Medical Reimbursement Representative, you play an integral role in delivering cost effective solutions for our patients by working with insurance companies to resolve issues associated with our patients' insurance claims.

In this role you will ensure timely follow-up on all patient accounts; including escalating payer trending concerns to leadership and timely communication with external departments; work with payers to ensure proper reimbursement on patient accounts, identify and prepare adjustments and write-offs; correct and resubmit claims (subject to policy); follow-up on daily correspondence (denials, short-pays); interface with insurance companies via phone and web portal to check claim status, submit written correspondence to payers and patients; interpret contracts with payers to ensure proper payment; send initial or secondary bills to insurance companies; process refunds and work to overturn insurance claim rejections while maintaining quality and productivity requirements.

To be successful in this role you will utilize Excel, Outlook, and Word and your critical thinking skills to ensure a high quality of work.

We offer instructor led training programs to set you up for success, in addition to a comprehensive benefits package that begins the first of the month after your start date and includes medical, dental and vision insurance as well as supplemental benefits, retail discounts and paid time off.

Additionally, we offer a flexible work schedule, starting your 8-hour day between 6 : 00am

• and 9 : 30am ending your day by 6 : 00pm.
• some locations require a 7 : 00am start time

Required Qualifications

1+ years of experience in a professional environment

Beginner level experience working in Excel, Outlook, and Word.

Preferred Qualifications

Home infusion or durable medical equipment (DME) experience

Strong attention to detail with a sense of urgency

Customer service skills

Ability to work in a team environment

Experience with medical billing or collections or experience with accounts payable (AP) or accounts receivable (AR)

Experience with healthcare reimbursement systems.

Education :

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is

$17.00 - $31.30

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.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https : / / jobs.cvshealth.com / us / en / benefits

We anticipate the application window for this opening will close on : 10 / 31 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex / gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.