Pharmacy Benefit Credit and Refund Specialist Coordinator, Revenue Cycle (Hybrid)

CVS Health; Monroeville (Allegheny County); On-site; USD 35,000 - 59,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Job summary

CVS Health Specialty Pharmacy in Monroeville, PA is hiring a full-time Pharmacy Benefit Credit and Refund Specialist Coordinator to resolve credit balances with payers and provide excellent patient and provider service. The role involves reviewing billing, posting cash, and communicating with insurers to ensure accurate resolutions in a fast-paced environment.

Ideal candidates have at least 1 year in healthcare insurance, strong Excel/Office skills, and the ability to commute to the Monroeville

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 on third-party insurance credit balances via phone, web, and written communication.
• Validate credit balances by checking billing and cash posting accuracy.
• Resolve credit balance issues, identify overpayments and revenue recognition.
• Perform revenue cycle analytics for healthcare accounts receivable.
• Initiate refunds, reverse claims, and post adjustments as needed.
• Maintain notes detailing actions taken to resolve balances.

Skills

Healthcare Insurance

Customer Service

Communication

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 Pharmacy Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up. The Pharmacy Benefit Credit and Refund Specialist Coordinator will ensure timely and accurate credit balance resolution with 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.

Key Responsibilities of the Pharmacy Benefit Credit and 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

• 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

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.

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.

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.

We anticipate the application window for this opening will close on: 09/11/2026

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