Sr Revenue Cycle Associate, CVS Health

CVS Health

Location:
United States, Illinois

Category:
Customer Service

Contract Type:
Employment contract

Salary:

46988.00 - 112200.00 USD / Year

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Job Description:

The Sr Revenue Cycle Associate role involves ensuring timely and appropriate submission of healthcare claims and payment for services rendered, mentoring peers, and addressing complex issues with payer systems. This includes working through claim denials, monitoring billing operations, and serving as a liaison between clinical and administrative staff.

Job Responsibility:

Work through complex payer issues within claim denials, underpayments, and/or missing payments
monitor timely claim submissions and posting payments via billing vendor
follow up with insurance companies on claim denials and submission of claim corrections
use tools like websites, electronic medical records, and payer systems for eligibility lookups and claim inquiries
contact payers to clarify incorrect payments or denials
maintain collections, adjustments, and write-offs policies
address edits from claim scrubbing software
analyze data and create reports for management
extract medical record details for billing and coding changes
resolve billing questions between clinical and administrative staff
respond to ticket system inquiries regarding patient statements/account balances
identify and escalate process improvements
draft training documentation for new processes
monitor team metrics and productivity
ensure accurate setup of practice management software for all locations
complete assignments in a timely manner
adapt to changes in procedures and environment.

Requirements:

Knowledge of medical terminology
experience in healthcare accounts receivable follow-up
thorough understanding of the health claim revenue cycle workflow process
minimum of Associate's degree, Bachelor's degree preferred
knowledge of reading and interpreting insurance Explanation of Benefits (EOB) statements
at least 2 years of experience working on coding denials with an understanding of NCCI edits preferred
solid understanding of insurance guidelines, including COB, HIPAA, CPT, ICD-10, Medicare, and managed care plans
proficiency in reading insurance plan and policy numbers from insurance ID cards
time management skills and ability to meet deadlines
experience in Excel/Google Sheets preferred
CPC credential is a plus
database query or business analyst experience a plus
US work authorization.

Nice to have:

CPC credential
database query experience
business analyst experience

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
employee stock purchase plan
wellness screenings
tobacco cessation programs
weight management programs
confidential counseling
financial coaching
paid time off
flexible work schedules
family leave
dependent care resources
tuition assistance
retiree medical access
competitive wages
health benefits.

Additional Information:

Job Posted:
March 19, 2025

Expiration:
September 17, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Sr Revenue Cycle Associate