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

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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

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

• 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.

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 03/31/2025

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