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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time Medical Claims Refund Specialist.  This role ensures timely credit balance resolution via refunds to patients, governmental agencies, and other third party payers. As part of the Refund team, you will work in a fast paced and team focused environment to resolve credit balances for insurance and patient balances. We will support you by offering all the tools and resources you need to be successful in a collaborative team based environment. Located in the Monroeville Facility, this opportunity also provides free parking.

Role Overview

• Schedule: Monday-Friday 8:00AM-4:30PM (Flex Start after training)
• Hybrid Role

What you will do

• Responsible for reviewing the validity of the credit balance by verifying accurate billing and posting procedures.
• Perform analytical activities for the reimbursement/collections department managing healthcare accounts receivable.
• Initiate refunds, offsets, and adjustments
• Analyze issues and search for solutions.
• Maintain supporting chronological notes that detail action taken to resolve outstanding balances.

Required Qualifications

• 1+ years’ experience performing health care reimbursement, medical billing or insurance collections, and/or account reconciliation/ account review/ account resolution.
• 1+ years’ experience in Microsoft Office Suite, specifically Microsoft Excel, Microsoft Outlook, and Microsoft Word
• Must live within a 1 hour commute from Monroeville, PA office. (Hybrid Role)

Preferred Qualifications

• Strong written and verbal communication skills.
• Strong team oriented and collaboration skills.

Education

• Verifiable High School Diploma or GED required

Pay Range

The typical pay range for this role is:

$17.00 - $28.45

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/04/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.