CVS Health is looking for a Medical Reimbursement Representative to play an integral role in delivering cost-effective solutions for our patients. You will work with insurance companies to resolve issues associated with patient claims and ensure proper reimbursement, helping to simplify health care one person at a time.
What You'll Do
- Work with insurance companies to resolve issues associated with patient insurance claims.
- Ensure timely follow-up on all patient accounts, including escalating payer trending concerns to leadership and timely communication with external departments.
- Work with payers to ensure proper reimbursement on patient accounts.
- Identify and prepare adjustments and write-offs.
- Correct and resubmit claims (subject to policy).
- Follow-up on daily correspondence (denials, short-pays).
- Interface with insurance companies via phone and web portal to check claim status.
- Submit written correspondence to payers and patients.
- Interpret contracts with payers to ensure proper payment.
- Send initial or secondary bills to insurance companies.
- Process refunds.
- Work to overturn insurance claim rejections while maintaining quality and productivity requirements.
What We're Looking For
- 1+ years of experience in a professional environment
- 1+ years experience working in Excel, Outlook, and Word
- Verifiable High School Diploma or GED
Nice to Have
- Home infusion or durable medical equipment (DME) experience
- Strong attention to detail with a sense of urgency
- Customer service skills
- Ability to work in a team environment
- Experience with medical billing or collections or experience with accounts payable (AP) or accounts receivable (AR)
- Experience with healthcare reimbursement systems
Technical Stack
- Excel
- Outlook
- Word
Benefits & Compensation
- Compensation: $17.00 - $28.46 per hour
- Comprehensive benefits package (medical, dental, vision) beginning first of month after start
- Supplemental benefits
- Retail discounts
- Paid time off
- Flexible work schedule (start between 6:00am and 9:30am, end by 6:00pm)
- Instructor led training programs
- Affordable medical plan options
- 401(k) plan with matching company contributions
- Employee stock purchase plan
- No-cost wellness screenings, tobacco cessation, weight management programs, confidential counseling, financial coaching
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
Work Mode
This is a full time position.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
