Medical Benefit Credit & Refund Coordinator - Monroeville, PA (Hybrid)

9025 CVS Shared Services Resources LLC; Monroeville (Allegheny County); On-site; USD 23,000 - 39,000; Full time

Benefits offered by this job

Free parking

Health benefits

Bonus eligibility

Paid time off

Job summary

CVS Health Specialty Pharmacy in Monroeville is seeking a full-time Medical Benefit Credit and Refund Specialist Coordinator. The role focuses on credit balance follow-up with third-party payers, ensuring accurate billing and timely refunds.

You will work in a collaborative team environment at the Monroeville facility with free parking. The position requires 1+ years in healthcare insurance, MS Office proficiency, and the ability to commute to Monroeville, PA.

Qualifications

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

Responsibilities

• Follow up with third party insurance regarding credit balances by phone, online, and in writing.
• Review and validate credit balances with accurate 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 adjustments.
• Maintain patient demographics and data collection systems with up-to-date notes.
• Respond to insurance companies and government payers about collection issues via telephone, web, or written communications.
• Contact patients and physician offices and insurance companies as needed to validate claims processing and payments.

Skills

Healthcare insurance experience

MS Excel

Communication

Teamwork

Education

High School Diploma or GED

Tools

Excel

Outlook

Word

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Medical Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up. The Medical Benefit Credit and Refund Specialist Coordinator will ensure timely and accurate credit balance resolution with third party payers while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of this team, you will work in a fast paced and team focused environment. We will support you by offering all the tools and resources you need to be successful in a collaborative team environment. Located in the Monroeville facility, this opportunity also provides free parking.

Key Responsibilities of the Medical Benefit Credit & Refund Specialist Coordinator:

• Third party insurance follow-up associated with the dispensing of prescription medication via telephone, Internet, and in writing.
• Review and validate the credit balance by verifying accurate billing and cash posting procedures.
• Resolve issues related to credit balances including identifying overpayments and validating appropriate 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 that detail action taken to resolve outstanding account balances.
• Maintain patient demographic information and data collection systems
• Research and respond by telephone, via the internet and in writing to insurance companies and governmental payers regarding collection issues and problems.
• Contact patients and Physician’s offices as well as insurance companies as needed in order to validate claims processing and payments.

Required 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.

Preferred Qualifications

• Medical insurance billing or collections experience.
• Customer service in a healthcare environment.
• Experience working in a healthcare reimbursement system.
• Effective customer service skills and experience that shows ability to work in a team environment.
• Attention to detail.
• Ability to utilize analytical skills.
• Ability to navigate through multiple tasks simultaneously and prioritize based on importance while displaying strong attention to detail.
• Ability to communicate with clientele in a professional manner; both verbally and written.

Education

• Verifiable High School Diploma or GED required.

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $28.46 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 11/27/2026

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

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.