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Senior Medical Reimbursement Representative

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States, Work At Home

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Category:
Customer Service

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Contract Type:
Employment contract

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Salary:

18.50 - 35.29 USD / Hour

Job Description:

As a Collector, you play an integral role in delivering cost effective solutions for our patients by working with insurance companies to resolve issues associated with our patients' insurance claims. In this role you will ensure timely follow-up on all patient accounts; including escalating payer trending concerns to leadership and timely communication 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 while maintaining quality and productivity requirements.

Job Responsibility:

  • Working with insurance companies to resolve issues associated with patients' insurance claims
  • ensuring timely follow-up on all patient accounts
  • escalating payer trending concerns to leadership
  • working with payers to ensure proper reimbursement on patient accounts
  • identifying and preparing adjustments and write-offs
  • correcting and resubmitting claims
  • following up on daily correspondence (denials, short-pays)
  • interfacing with insurance companies via phone and web portal
  • interpreting contracts with payers
  • sending initial or secondary bills to insurance companies
  • processing refunds
  • working to overturn insurance claim rejections

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
  • 401(k) plan with matching company contributions
  • employee stock purchase plan
  • wellness screenings
  • tobacco cessation and weight management programs
  • confidential counseling
  • financial coaching
  • family leave
  • dependent care resources
  • colleague assistance programs
  • tuition assistance
  • retiree medical access

Additional Information:

Job Posted:
September 16, 2025

Expiration:
September 30, 2025

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:
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