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CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time Billing and Collections Revenue Cycle Management 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.
Job Responsibility:
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 for upskills training
Assist with working complex accounts related to insurance billing and collections and other third party insurance claim billing associated with the dispensing medication and 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
Verifiable High School Diploma or GED required
Nice to have:
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
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