Medical Benefit Credit & Refund Coordinator, CVS Health

Medical Benefit Credit & Refund Coordinator

CVS Health

Location:

United States, Monroeville

Category:

Customer Service

Contract Type:

Employment contract

Salary:

17.00 - 28.46 USD / Hour

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Job Description:

CVS Health Specialty Pharmacy in the Monroeville area is looking for a Medical Benefit Credit and Refund Coordinator to handle insurance credit balance follow-up. The role involves third-party insurance interaction, credit balance reviews, issue resolution related to overpayments, refunds initiation, managing patient records, and other healthcare revenue cycle responsibilities in a collaborative hybrid work environment.

Job Responsibility:

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

Requirements:

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
Verifiable High School Diploma or GED required

Nice to have:

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

What we offer:

Medical, dental, and vision benefits
Company’s 401(k) retirement savings plan
Employee Stock Purchase Plan
Fully-paid term life insurance plan
Short-term and long-term disability benefits
Well-being programs
Education assistance
Free development courses
CVS store discount
Discount programs with participating partners
Paid Time Off (PTO)
Paid holidays

Additional Information:

Job Posted:

March 18, 2025

Expiration:

April 30, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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