Hybrid Pharmacy Benefit Credit & Refund Specialist

CVS Health Corporation; Monroeville (Allegheny County); Hybrid; USD 23,000 - 39,000; Full time

Job summary

CVS Health in Monroeville, PA is seeking a full-time Pharmacy Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up and ensure timely resolution with payers while delivering excellent service to patients, healthcare professionals, and insurance carriers.

In a fast-paced, team-focused environment, you will review billing, validate cash postings, initiate refunds, and maintain notes and patient demographics as you support revenue cycle activities and

Qualifications

• 1+ years of Healthcare Insurance related experience.
• Experience using Microsoft Office products specifically Excel, Outlook, and Word.
• Must be able to commute to the Monroeville, PA office.

Responsibilities

• Follow-up with third party insurers regarding credit balances related to dispensing of prescription medications via telephone, internet, and written communications.
• Review and validate credit balances by verifying billing and cash posting procedures.
• Resolve issues related to credit balances, including identifying overpayments and validating revenue recognition.
• Perform analytical activities for the revenue cycle department managing healthcare accounts receivable.
• Initiate refunds, reverse claims, request payer offsets, and post adjustment transactions.
• Maintain supporting chronological notes detailing actions taken to resolve outstanding balances.
• Maintain patient demographic information and data collection systems.
• Research and respond to insurance companies and governmental payers regarding collection issues by telephone, internet, and written communications.
• Contact patients and physicians as well as insurance companies as needed to validate claims processing and payments.

Skills

Healthcare Insurance

Excel

Outlook

Word

Education

High School Diploma or GED

Job description

CVS Health in Monroeville, PA is seeking a full-time Pharmacy Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up and ensure timely resolution with payers while delivering excellent service to patients, healthcare professionals, and insurance carriers.

In a fast-paced, team-focused environment, you will review billing, validate cash postings, initiate refunds, and maintain notes and patient demographics as you support revenue cycle activities and