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Coordinator, Revenue Cycle

4 months ago

Providence, United States CVS Health Full time

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

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**:
As a Coordinator, you will support the Medicare Part B Team to reduce bad debt, alleviate audit risk and ensure compliance with all federal/state requirements and CVS Health obligations. It is the responsibility of the Coordinator to perform timely and accurate reviews/finalizations of Medicare Part B production billings in the exception queues. The Coordinator monitors queues, claim reports and partners with stakeholders (stores, providers, billing processors, internal/external contacts) to obtain/verify the information necessary to submit claims to Medicare Part B; in accordance with CMS guidelines. This function supports the CVS Revenue Cycle goal of timely and accurate billing of pharmacy and medical claims to applicable payers.
- Responsibilities of the Coordinator include: _
- Performing trend analysis on Medicare Part B claim exceptions.
- Closely monitoring open deposit exceptions and contacting remittance processors, payers, and/or other internal departments to resolve issues associated with missing/incomplete remittance files.
- Coordinate files for write offs.
- Obtaining required documentation as a response to requests from the Medicare Part B vendor and/or CMS.
- Timely and effective communication to internal and external parties (including vendors) to report and remediate identified issues.

**Required Qualifications**:

- 1+ years in Retail Pharmacy, PBM and/or Healthcare Account Management (accounts receivables).

**Preferred Qualifications**:

- Good diagnostic and organizational skills with a strong attention to detail, accuracy, and follow through.
- Demonstrated ability to communicate clearly, accurately, and tactfully, both verbally, and in writing, with both internal and external business partners.
- Ability to make intelligent decisions independently and/or escalate issues.
- Ability to work individually, with a team, and with their manager to systematically identify and define problems.
- Ability to receive guidance and supervision, follow instructions and procedures.
- Ability to write clear instructions for store personnel and peers to follow to minimize bad debt for future fills.
- Flexibility to adapt to a changing environment, quickly making sound decisions.
- Strong organizational skills, attention to detail, accuracy and follow through.
- Knowledge of medical billing and/or Medicare Part B Policy and Regulations.
- Ability to work in strict confidence, ensuring the confidentiality of the patient and medical and financial records, always and in compliance with the company and HIPAA Privacy guidelines.

**Education**
- High School Diploma or GED required

**Pay Range**

The typical pay range for this role is:
$17.00 - $29.88

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.