Minute Clinic Accounts Receivable Associate, Senior Coordinator, Revenue Cycle

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

CVS Health/minute clinic is dedicated to helping people on their path to better health as part of the largest integrated pharmacy company in the United States. Through the company's more than 7,600 CVS/pharmacy stores; its leading pharmacy benefit manager serving more than 60 million plan members; and its retail health clinic system, the largest in the nation with more than 970 MinuteClinic locations, it is a market leader in mail order, retail and specialty pharmacy, retail clinics, and Medicare Part D Prescription Drug Plans. As a pharmacy innovation company with an unmatched breadth of capabilities, CVS Health continually strives to improve health and lower costs by developing new approaches.
The Minute Clinic Accounts Receivable Associate, Senior Coordinator, 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

Required Qualifications

• The coordinator 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.

• Minimum of 2 years of Medical Billing Experience or health plan claims adjudication experience

Preferred Qualifications

• 3-5 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

Anticipated Weekly Hours