Pharmacy Benefit Credit & Refund Specialist Coordinator, CVS Health

Pharmacy Benefit Credit & Refund Specialist 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 is seeking a Pharmacy Benefit Credit & Refund Specialist Coordinator in Monroeville, PA, to handle insurance credit balance follow-up and ensure timely and accurate credit balance resolution with third-party payers. This is a hybrid role requiring strong analytical, customer service, and organizational skills.

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.

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:

Affordable medical plan options
401(k) plan including matching company contributions
employee stock purchase plan
no-cost programs for wellness screenings, tobacco cessation, and weight management programs
confidential counseling and financial coaching
paid time off
flexible work schedules
family leave
dependent care resources
colleague assistance programs
tuition assistance
retiree medical access
other benefits depending on eligibility.

Additional Information:

Job Posted:

March 19, 2025

Expiration:

May 14, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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