Pharmacy Reimbursement Specialist

4 days ago


Hamilton, Ohio, United States CVS Health Full time
Job Summary

We are seeking a highly skilled Pharmacy Reimbursement Representative to join our team at CVS Health. As a Pharmacy Reimbursement Representative, you will play a critical role in ensuring accurate and timely billing practices for our pharmacy operations.

Key Responsibilities
  • Qualify, prepare, and submit claims to the Copay Assistance program
  • Work with pharmacy operations staff, prescriber offices, third-party payers, patients, and/or their responsible parties and claim processors
  • Follow processes to assist with processing, insurance verification, and authorization, revenue cycle management, compliance, and documentation, as well as customer service and issue resolution
  • Provide support in ensuring accurate billing, efficient revenue flow, and compliance with regulations
Requirements
  • Minimum 1 year of experience performing healthcare reimbursement, medical insurance/billing, or related work
  • Customer service skills with the ability to work in a team environment
  • Experience in MS Word, Excel, and Outlook
  • Must live within a 1-hour commute of the Monroeville, PA office
Preferred Qualifications
  • Ability to prioritize daily tasks
  • Working knowledge of medical terminology
  • Experience working with healthcare reimbursement systems
  • Working knowledge of problem-solving and decision-making skills
  • Certified Billing and Coding Specialist (CBCS) preferred
What We Offer

At CVS Health, we offer a comprehensive benefits package, including medical, dental, and vision benefits, as well as a 401(k) retirement savings plan and employee stock purchase plan. We also offer paid time off, paid holidays, and a fully-paid term life insurance plan. Additionally, we provide opportunities for professional development and growth within the company.



  • Hamilton, Ohio, United States Kettering Health Full time

    Job Title: Clinical Oncology Pharmacy SpecialistKettering Health is a leading healthcare provider in southwest Ohio, committed to delivering high-quality care to our patients. We are seeking a highly skilled Clinical Oncology Pharmacy Specialist to join our team.Job Summary:The Clinical Oncology Pharmacy Specialist will work closely with our oncology...


  • Hamilton, Ohio, United States Kettering Health Full time

    About the RoleKettering Health is seeking a highly skilled Clinical Oncology Pharmacy Specialist to join our team. As a key member of our oncology team, you will work closely with our oncology providers and nursing staff to deliver optimal care to our patients.ResponsibilitiesCoordinate and deliver pharmacy services in compliance with all applicable...


  • Hamilton, Ohio, United States Kettering Health Full time

    About the RoleKettering Health is seeking a highly skilled Clinical Oncology Pharmacy Specialist to join our team. As a key member of our oncology department, you will play a critical role in delivering optimal care to our patients.Key ResponsibilitiesCoordinate and deliver pharmacy services in compliance with all applicable policies, regulatory agency...


  • Hamilton, Ohio, United States Kettering Health Full time

    Job SummaryKettering Health is seeking a highly skilled Clinical Oncology Pharmacy Specialist to join our team. As a key member of our oncology team, you will work closely with our oncology providers and nursing staff to deliver optimal care to our patients.ResponsibilitiesCoordinate and deliver pharmacy services in compliance with all applicable policies,...

  • Pharmacy Technician

    2 weeks ago


    Hamilton, Ohio, United States Optum Full time

    Pharmacy Technician Job DescriptionWe are seeking a skilled Pharmacy Technician to join our team at Optum in Kendallville, Indiana. As a Pharmacy Technician, you will play a vital role in supporting the pharmacy team and ensuring the smooth operation of our pharmacy services.Key Responsibilities:Fills prescription orders and makes them available for...


  • Hamilton, Ohio, United States CVS Health Full time

    Job SummaryCVS Health is seeking a highly skilled Medical Collections Specialist to join our team in the Monroeville area. As a key member of our Billing and Reimbursement Team, you will be responsible for ensuring timely and accurate billing to insurance providers, researching and resolving billing issues, and maintaining patient demographic information and...


  • Hamilton, Ohio, United States CVS Health Full time

    Job SummaryCVS Health is seeking a highly skilled Medical Collections Specialist to join our team in the Monroeville area. As a key member of our Billing and Reimbursement Team, you will play a critical role in ensuring timely and accurate billing to insurance providers.Key ResponsibilitiesTransmit or submit paper and/or electronic claims to insurance payors...


  • Hamilton, Ohio, United States Excela Health Full time

    Job SummaryWe are seeking a skilled Licensed Practical Nurse (LPN) to join our Cardiology team at Excela Health. As an LPN, you will play a vital role in providing high-quality patient care and supporting our physicians in delivering exceptional medical services.Key ResponsibilitiesProvide direct patient care, including lab tests, treatments, and medication...


  • Hamilton, Ohio, United States CVS Health Full time

    Job SummaryCVS Health is seeking a skilled Medical Insurance Collections Representative to join our team in the Monroeville area. As a key member of our Billing and Reimbursement Team, you will play a critical role in ensuring timely and accurate billing to insurance providers.Key ResponsibilitiesTransmit or submit paper and/or electronic claims to insurance...


  • Hamilton, Ohio, United States Doctor's Choice Placement Services, Inc Full time

    ## Cardiology Specialist Opportunity ### Overview Doctor's Choice Placement Services, Inc is seeking a skilled Cardiology Specialist to join our team in Southwest Pennsylvania. As a leading healthcare provider, we offer a unique opportunity to work with a talented group of physicians and contribute to the delivery of exceptional patient care. ###...


  • Hamilton, Ohio, United States DeCoach Recovery Centre Full time

    Job DescriptionAbout Us:DeCoach Recovery Centre is a leading addiction treatment centre dedicated to providing comprehensive and compassionate care to individuals struggling with substance use disorders. We offer a range of evidence-based treatments and therapies tailored to each patient's unique needs, with a focus on long-term recovery and wellness.The...


  • Hamilton, Ohio, United States Wellbe Senior Medical Full time

    Job Overview:WELLBE INTRODUCTIONJoin us in transforming healthcare delivery. Our mission is to innovate the way medical services are provided across the nation.At WellBe, we are dedicated to offering home-based medical care to those who need it most, significantly impacting lives by delivering care in the comfort of patients' homes. Our primary care services...

  • CT Technologist

    3 weeks ago


    Hamilton, Ohio, United States Thomas Jefferson University & Jefferson Health Full time

    Diagnostic Imaging Specialist OpportunityAt Thomas Jefferson University & Jefferson Health, we're committed to delivering exceptional patient care and advancing the field of diagnostic imaging. As a CT Technologist, you'll play a critical role in producing high-quality images that help our medical team diagnose and treat a range of conditions.Key...


  • Hamilton, Ohio, United States Trilogy Health Services Full time

    Job SummaryWe are seeking a highly skilled Infection Control Specialist to join our team at Trilogy Health Services. As a key member of our clinical leadership team, you will be responsible for overseeing our wound care program and developing and maintaining an active Infection Control program.Key ResponsibilitiesOversight of the wound care programDevelops...


  • Hamilton, Ohio, United States Glade Run Lutheran Services Full time

    Job SummaryWe are seeking a highly skilled and compassionate Psychiatric Medication Specialist to join our team at Glade Run Lutheran Services. As a key member of our Mobile Medication Program, you will play a vital role in providing essential medication services to individuals in need.Key ResponsibilitiesParticipate in the Mobile Medication Program...

  • Clinical Pharmacist

    1 month ago


    Hamilton, Ohio, United States Specialty Medical Staffing Full time

    Position: Staff PharmacistOverview:Specialty Medical Staffing is seeking a qualified Pharmacist for a rewarding opportunity in a hospital setting. This role is with a reputable healthcare provider, known for its commitment to excellence in patient care.Key Responsibilities:As a Staff Pharmacist, you will be responsible for:Providing pharmaceutical care to...


  • Hamilton, Ohio, United States Glade Run Lutheran Services Full time

    Job SummaryWe are seeking a highly skilled and compassionate Psychiatric Medication Specialist to join our team at Glade Run Lutheran Services. As a key member of our Mobile Medication Program, you will play a vital role in providing essential medication services to individuals in need.Key ResponsibilitiesParticipate in the Mobile Medication Program...


  • Hamilton, Ohio, United States DeCoach Recovery Centre Full time

    Position OverviewAbout DeCoach Recovery:DeCoach Recovery is a premier addiction treatment facility committed to delivering thorough and empathetic support to individuals facing substance use challenges. Our approach incorporates a variety of evidence-based methodologies and therapies, customized to meet the distinct needs of each patient, emphasizing...


  • Hamilton, Ohio, United States Horizon Farm Credit Full time

    Job Title: Customer Service SpecialistHorizon Farm Credit is seeking a highly skilled Customer Service Specialist to join our team. As a key member of our branch team, you will provide exceptional customer service, process customer convenience service requests, and handle general account inquiries.Key Responsibilities:Provide prompt and professional service...


  • Hamilton, Ohio, United States 80 Acres Farms Full time

    Job DescriptionAbout 80 Acres Farms80 Acres Farms is a leading vertical farming company that is revolutionizing the way food is grown and distributed. Our mission is to make a positive impact on the environment and provide fresh, healthy produce to our customers.Job SummaryWe are seeking a highly organized and detail-oriented People Operations Specialist to...