Medical Benefit Credit & Refund Coordinator

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.

Key Responsibilities include third party insurance follow-up associated with the dispensing of prescription medication via telephone, Internet, and in writing; reviewing and validating credit balances by verifying accurate billing and cash posting procedures; resolving issues related to credit balances including identifying overpayments and validating appropriate revenue recognition; performing analytical activities for the revenue cycle department managing healthcare accounts receivable; initiating refunds, reversing claims, requesting payer offsets, and posting adjustment transactions; maintaining supporting chronological notes that detail action taken to resolve outstanding account balances; maintaining patient demographic information and data collection systems; researching and responding by telephone, via the internet and in writing to insurance companies and governmental payers regarding collection issues and problems; contacting patients and Physician’s offices as well as insurance companies as needed in order to validate claims processing and payments.

Required qualifications include 1+ years of Healthcare Insurance related experience, experience using Microsoft Office products specifically Excel, Outlook, and Word, and ability to commute to the Monroeville, PA office.

Preferred qualifications include 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, and ability to communicate with clientele in a professional manner both verbally and written. Education requirement is a verifiable High School Diploma or GED. The position is full-time with anticipated weekly hours of 40.

Located in the Monroeville facility, this opportunity also provides free parking. CVS Health offers a comprehensive and competitive mix of pay and benefits including affordable medical plan options, a 401(k) plan with matching company contributions, employee stock purchase plan, no-cost wellness programs, paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.