CVS Health, Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time insurance follow up representative. The primary responsibilities of a Medical Insurance Collector are to ensure timely and accurate account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers.
Responsible for all third party follow-up associated with the dispensing of prescription medication; maintain supporting chronological notes that detail action taken to resolve outstanding account balances. Maintains patient demographic information and data collection systems. Work all billing/collection reports, queues, or diversions according to payer and company policy guidelines.
Researches and responds by telephone, via the Internet and in writing to insurance companies and governmental payors regarding billing issues and problems. Follows up on submitted claims; monitors unpaid claims, initiates appeals and resubmits claims as necessary. Easily identifies payor trends, prepares projects for escalations and all other duties as assigned to ensure timely and accurate reimbursement.
-Transmit or submit claims (paper, electronic) to insurance payors for reimbursement
-Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors
-Provide detailed follow up with patients and payors in the form of, but not limited to phone calls, fax transmittals and e-mails
-Contact patients and Physician's offices as needed in order to expedite claims processing
-Obtain accurate demographic, insurance and financial information from patients to ensure all account information is accurate
-Located in the Monroeville Facility, this opportunity also provides free parking
- 1 + years experience performing health care reimbursement, medical billing or insurance collections
- 1+ years experience in Microsoft Office, specifically Excel, Outlook and Word
-1+ years of experience with collections associated with Medical billing or collections in health care
- Customer Service in a health care environment and with healthcare reimbursement
- Ability to communicate with clientele in a professional manner; both written and verbal
- Proven effective customer service skills and experience that shows ability to work independently and in a team environment
- Ability to navigate through multiple tasks simultaneously and prioritize based on importance while displaying strong attention to detail
Verifiable High School Diploma or GED required.
It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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