CVS Health

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Accounts Receivable Associate, Senior

at CVS Health

Posted: 9/12/2019
Job Reference #: 1079323BR
Keywords: billing, compliance

Job Description

Job Description
The Senior MinuteClinic Accounts Receivable Associate will be responsible for:

Managing a high volume of medical claims that have denied by refuting the denials within payer guidelines through accurate review, correction, and resubmission

Provide representation when needed of the Accounts Receivable area to internal dept.’s as well as external dept.’s, clients, vendors and processors to clearly relay situational occurrences and provide support when needed

The account receivable associate will be responsible for identifying and quantifying trends/issues, developing potential solutions and then effectively communicate them to the appropriate members of the management team along with what the potential impact could be.

Effectively prioritize and manage outstanding refund requests and overpayments to support contract and legal adherence with all payers including Medicare and Medicaid.

Identify and implement process efficiencies across the dept. including automation opportunities or workflow enhancement opportunities to reduce manual efforts and improve productivity and overall compliance

Recognize and Identify coding deficiencies and exercise the appropriate action based upon compliance and CMS regulations

Identify key stake holders or primary contacts within payer communities to drive more effective processes

The specialist must have a clear understanding of the intricacies of medical billing encountered in such areas like ambulatory care, physician/provider offices, or professional billing settings. In addition, a clear understanding of CPT, ICD-9/10, CMS 1500 claim formatting, as well as, familiarity with Electronic Data Interchange (EDI) transmission, Electronic Health Record or encounter charge creation is key to success in this position. Knowledge of national HIPPA, PHI, and other regulatory requirements to help ensure compliance when working claims data is important.

Required Qualifications
2 or more years of Medical Billing Experience or health plan claims adjudication experience

Preferred Qualifications
3 or more years of Medical Billing experience or health plan claims adjudication experience
Technical Certificate in Medical Billing
Microsoft Office with a focus on Excel, Outlook, and Word
Time management skills
The ability to multi-task
Athena Practice Management experience

Education
Verifiable High School Diploma or GED required

Business Overview
It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!