Medical Reimbursement Representative, CVS Health

CVS Health

Location:
United States, Illinois

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 31.30 USD / Hour

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Job Description:

As a Medical Reimbursement Representative, you will play an integral role in delivering cost effective solutions for patients by working with insurance companies to resolve issues associated with insurance claims. Your responsibilities will include working with payers to ensure proper reimbursement and maintaining a high quality of work using skills in Excel, Outlook, and Word. The company offers a comprehensive benefits package starting the first month after employment.

Job Responsibility:

Work with insurance companies to resolve issues associated with patients’ insurance claims
Ensure timely follow-up on all patient accounts
escalate payer trending concerns to leadership and communicate with external departments
Work with payers to ensure proper reimbursement on patient accounts
Identify and prepare adjustments and write-offs
Correct and resubmit claims (subject to policy)
Follow-up on daily correspondence (denials, short-pays)
Interface with insurance companies via phone and web portal to check claim status
Submit written correspondence to payers and patients
Interpret contracts with payers to ensure proper payment
Send initial or secondary bills to insurance companies
Process refunds and work to overturn insurance claim rejections
Maintain quality and productivity requirements
Utilize Excel, Outlook, and Word and critical thinking skills to ensure a high quality of work

Requirements:

1+ years of experience in a professional environment
Beginner level experience working in Excel, Outlook, and Word
Verifiable High School Diploma or GED required

Nice to have:

Home infusion or durable medical equipment (DME) experience
Strong attention to detail with a sense of urgency
Customer service skills
ability to work in a team environment
Experience with medical billing or collections or experience with accounts payable (AP) or accounts receivable (AR)
Experience with healthcare reimbursement systems

What we offer:

Medical, dental and vision insurance
Supplemental benefits
Retail discounts
Paid time off
Flexible work schedule
Wellness screenings
Tobacco cessation program
Weight management program
Confidential counseling
Financial coaching
401(k) plan with matching company contributions
Employee stock purchase plan
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
November 07, 2025

Expiration:
November 21, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Medical Reimbursement Representative