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Sr Revenue Cycle Associate

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States, Illinois

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Category:
Customer Service

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Contract Type:
Employment contract

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Salary:

46988.00 - 112200.00 USD / Year
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Job Description:

The Sr Revenue Cycle Associate role involves ensuring timely and appropriate submission of healthcare claims and payment for services rendered, mentoring peers, and addressing complex issues with payer systems. This includes working through claim denials, monitoring billing operations, and serving as a liaison between clinical and administrative staff.

Job Responsibility:

  • Work through complex payer issues within claim denials, underpayments, and/or missing payments
  • monitor timely claim submissions and posting payments via billing vendor
  • follow up with insurance companies on claim denials and submission of claim corrections
  • use tools like websites, electronic medical records, and payer systems for eligibility lookups and claim inquiries
  • contact payers to clarify incorrect payments or denials
  • maintain collections, adjustments, and write-offs policies
  • address edits from claim scrubbing software
  • analyze data and create reports for management
  • extract medical record details for billing and coding changes
  • resolve billing questions between clinical and administrative staff
  • respond to ticket system inquiries regarding patient statements/account balances
  • identify and escalate process improvements
  • draft training documentation for new processes
  • monitor team metrics and productivity
  • ensure accurate setup of practice management software for all locations
  • complete assignments in a timely manner
  • adapt to changes in procedures and environment.

Requirements:

  • Knowledge of medical terminology
  • experience in healthcare accounts receivable follow-up
  • thorough understanding of the health claim revenue cycle workflow process
  • minimum of Associate's degree, Bachelor's degree preferred
  • knowledge of reading and interpreting insurance Explanation of Benefits (EOB) statements
  • at least 2 years of experience working on coding denials with an understanding of NCCI edits preferred
  • solid understanding of insurance guidelines, including COB, HIPAA, CPT, ICD-10, Medicare, and managed care plans
  • proficiency in reading insurance plan and policy numbers from insurance ID cards
  • time management skills and ability to meet deadlines
  • experience in Excel/Google Sheets preferred
  • CPC credential is a plus
  • database query or business analyst experience a plus
  • US work authorization.

Nice to have:

  • CPC credential
  • database query experience
  • business analyst experience
What we offer:
  • Affordable medical plan options
  • 401(k) plan with matching company contributions
  • employee stock purchase plan
  • wellness screenings
  • tobacco cessation programs
  • weight management programs
  • confidential counseling
  • financial coaching
  • paid time off
  • flexible work schedules
  • family leave
  • dependent care resources
  • tuition assistance
  • retiree medical access
  • competitive wages
  • health benefits.

Additional Information:

Job Posted:
March 19, 2025

Expiration:
September 17, 2025

Employment Type:
Fulltime
Work Type:
Remote work
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