Senior Lead Coordinator, Revenue Cycle

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

CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time Billing and Collections Revenue Cycle Management Team Lead. As a Team Lead, you will ensure timely and accurate billing and collections for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of the billing and reimbursement team, you will work in a fast paced and team focused environment to ensure timely and accurate billing and collections to copay assistance programs.

We will support you by offering all the tools and resources you need to be successful in a collaborative team based environment.

Located in the Monroeville facility, this opportunity also provides free parking.

Key Responsibilities of the Billing and Collections Revenue Cycle Management Team Lead:

• Review routine reports to ensure department Key Performance Indicators and Metrics are consistently met. Provide feedback to leaders and colleagues regarding areas of success and concern and suggest mitigation plans.
• Identify and quantify trends and variances. Effectively communicate information to the appropriate members of the management team along with the potential impact.
• Assist leadership in building and maintaining a high performing, highly engaged team.
• Provide excellent mentorship and support to the department’s colleagues.
• Assist in designing and implementing department level training programs and lead job specific training for department new hires and for upskills training.
• Assist with working complex accounts related to insurance billing and collections and other third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer.
• Resolve complex insurance problems and patient inquiries that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Maintain supporting and chronological notes that detail action taken to resolve billing edits.
• Maintain patient demographic and insurance information and data collections systems, including all.
• Complete billing reports, queues, or diversions according to payer and company policy guidelines
• Research and respond to insurance companies and governmental payors regarding billing issues or related questions by telephone, via the internet, and in writing.
• Contact patients, physician's offices or insurance carriers as needed in order to expedite billing claims.

Required Qualifications

• 2+ 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.
• Training, coaching and mentorship with other colleagues.
• 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

Time Type

Pay Range

The typical pay range for this role is:

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. 
 

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:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• 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

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