Accounts Receivable Collections Specialist- Monroeville, PA (Hybrid)

Pharmacy Reconciliation Specialist

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 The role is responsible for managing follow-up and reconciliation of prescription medication payments, with a focus on resolving unapplied cash and forward balances. This includes investigating payment discrepancies, collaborating with internal teams, and communicating with patients, payers, and providers to ensure accurate application of funds. The position requires strong analytical skills, attention to detail, and the ability to work independently while maintaining thorough documentation and contributing to process improvement initiatives.

• Conduct third-party follow-up related to prescription medication dispensing via phone, internet, and written communication.
• Investigate and resolve aged unapplied cash items using worklists and reconciliation tools.
• Identify and process forward balances (e.g., SharePoint Forward Balance forms).
• Resolve issues with unapplied or recouped payments due to incomplete information, therapy changes, or pharmacy / shipping errors.
• Collaborate with cash posting teams to ensure accurate payment application to patient accounts and claims.
• Maintain chronological notes and audit trails detailing actions taken to resolve account balances.
• Monitor and report on unapplied cash trends and resolution metrics.
• Research and respond to insurance companies and government payers regarding payment discrepancies.
• Contact patients, physician offices, and insurance companies to expedite resolution.
• Escalate unresolved items or discrepancies to appropriate departments or leadership.
• Respond to internal inquiries related to unapplied cash and forward balances.
• Participate in process improvement initiatives to enhance reconciliation accuracy and efficiency.

Required Qualifications

Preferred Qualifications

Education High School Diploma or Equivalent

Anticipated Weekly Hours 40

Time Type Full time

Pay Range

The typical pay range for this role is :

$17.00 - $28.46

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.

We anticipate the application window for this opening will close on : 10 / 02 / 2025

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