Medical Billing Representative, Revenue Cycle (Hybrid)

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

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources, based on eligibility

Job summary

CVS Health in Monroeville, PA is seeking a Medical Billing Representative to submit medical claims to insurers, verify coverage, and resolve payer and patient issues. You’ll work with 837, CMS-1500, and CVS systems to ensure accuracy and compliance.

Qualifications include 1+ year healthcare insurance experience and proficiency with Excel, Outlook and Word. Must live within 1 hour of the Monroeville office and be able to work in a fast‑paced, detail‑driven team environment.

Qualifications

• 1+ years Healthcare Insurance experience.
• Proficient in Excel, Outlook & Word.
• Live within 1 hour of the Monroeville, PA office.
• Ability to submit medical claims and verify eligibility.

Responsibilities

• Creating and submitting medical claims to insurance companies within timely filing and ensuring accuracy within payer guidelines and preferred bill methods (i.e., 837, website, spreadsheets, and CMS-1500).
• Validating coverage and eligibility prior to claim billing.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Maintaining supporting and chronological notes that detail action taken to resolve billing edits.
• Maintain updated information within the necessary AR/CVS systems that are in accordance with the company policy.
• Following the company compliance regulations.
• Being an effective communicator with patients, providers, and insurance agents to resolve account issues.
• Research information on provider portals.
• Collaborate with collections team to ensure that payer guidelines are being met.
• Ability to spot inaccuracies or inconsistencies in medical documentation and ensure precision.

Skills

Healthcare insurance experience

Microsoft Excel

Microsoft Outlook

Microsoft Word

Communication skills

Attention to detail

Time management

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

Position Summary

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.

The key responsibilities of the Medical Billing Representative are

• Creating and submitting medical claims to insurance companies within timely filing and ensuring accuracy within payer guidelines and preferred bill methods (i.e., 837, website, spreadsheets, and CMS-1500).


• Validating coverage and eligibility prior to claim billing.


• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.


• Maintaining supporting and chronological notes that detail action taken to resolve billing edits.


• Maintain updated information within the necessary AR/CVS systems that are in accordance with the company policy.


• Following the company compliance regulations.


• Being an effective communicator with patients, providers, and insurance agents to resolve account issues.


• Research information on provider portals.


• Collaborate with collections team to ensure that payer guidelines are being met.


• Ability to spot inaccuracies or inconsistencies in medical documentation and ensure precision.

Required Qualifications

• 1+ years Healthcare Insurance experience.


• Experience using Microsoft Office products specifically Excel, Outlook and Word.


• Must live within 1 hour of the Monroeville, PA office.

Preferred Qualifications

• Insurance billing or collections experience


• Customer service in a healthcare and team environment


• Attention to detail


• Ability to multitask and meet deadlines


• Ability to utilize problem solving skills


• Ability to communicate with clientele in a professional manner

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 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

• medical, dental, and vision coverage


• paid time off


• retirement savings options


• wellness programs


• other resources, based on eligibility

We anticipate the application window for this opening will close on: 11/13/2026

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.