At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.
What you will do:
- Manages the end-to-end billing process, ensuring accurate and timely generation of invoices for healthcare services rendered.
- Maintains and updates billing systems and software, ensuring they are configured correctly to generate accurate and compliant invoices.
- Monitors key performance indicators, such as days in accounts receivable and denial rates, and implements strategies to improve billing efficiency and cash flow.
- Conducts internal audits and quality checks to identify and rectify billing errors or non-compliance issues.
- Develops and maintains documentation for billing processes, including standard operating procedures, job aids, and training materials.
- Handles and resolves claim rejections, underpayments, and other billing discrepancies, working closely with payers, providers, and internal stakeholders to ensure accurate and timely claim adjudication.
- Manages escalated billing issues or complaints, working closely with cross-functional teams to address and resolve issues in a timely manner.
- Provides training and mentorship to billing team members, ensuring they have the necessary knowledge and skills to perform their roles effectively.
- Ensures that all team members have access to accurate and up-to-date process documentation.
Required Qualifications
- Adept at problem solving and decision making skills
- Demonstrated success solving complex problems and executing on those solutions
- Strong interpersonal and communication skills
Preferred Qualifications
- Understanding of Medicare and CMS regulations
- Ability to utilize Excel
Education
- High school diploma or equivalent required.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$18.50 - $42.35
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.
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
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
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Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
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No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
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Benefit solutions that address the different needs and preferences of our colleagues including 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.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/24/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
