Senior Coordinator, Revenue Cycle, CVS Health

CVS Health

Location:
United States

Category:
Customer Service

Contract Type:
Employment contract

Salary:

18.50 - 38.82 USD / Hour

Save Job

Apply Position

Job Description:

Review qualification requirements for Medicare Part B patients focusing on Specialty infusion therapies. Other responsibilities include creating Medicare forms and qualification packets, collaborating with the Medicare Billing and audit teams, and conducting education sessions with Sales and Referral sources.

Job Responsibility:

Review qualification requirements for Medicare Part B patients focusing on Specialty infusion therapies
Create Medicare forms and qualification packets
Collaborate with the Medicare Billing and audit teams
Conduct education sessions with Sales and Referral sources
Review clinical documentation for qualification criteria as outlined by Medicare Part B guidelines
Document clinical review in Epic
Prepare Medicare Part B and Managed Medicare payer qualification packets
Create Medicare ABN form
Collaborate with Billing team on Medicare Part B infusion claim edits
Conduct continued medical necessity reviews for long term, cyclical therapies
Conduct education sessions with Sales Liaisons
Participate with Sales and Referral sources in qualification discussions
Collaborate with CVS Specialty Pharmacy as needed
Review Medicare medical necessity denials
Submit documentation of continued medical need and other supporting information into Medicare appeals portal
Understanding and staying updated on Medicare Fee for Service LCDs and Policy articles

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:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
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

Additional Information:

Job Posted:
September 28, 2025

Expiration:
October 10, 2025

Employment Type:

Fulltime

Work Type:

Remote work

View All Jobs In This Company

Job Link Share:

Senior Coordinator, Revenue Cycle