Senior Lead Coordinator, Revenue Cycle (Hybrid)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

About the role

CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full-time Revenue Cycle 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. This opportunity is located in the Monroeville facility and provides free parking.

Responsibilities

• 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 upskilling training.
• Assist with working complex accounts related to insurance billing and collections and other third-party insurance claim billing associated with dispensing medication 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.
• 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.

Requirements

• 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.

Qualifications

Verifiable High School Diploma or GED required.

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.

Pay

The typical pay range for this role is $18.50 - $35.29 per hour. 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.

Schedule

• Full-time
• 40 anticipated weekly hours

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. Benefits include:

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility