[Hiring] Senior Coordinator, Revenue Cycle @CVS Health

Role Description

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.
• Providing representation when needed of the Accounts Receivable area to internal departments as well as external departments, clients, vendors, and processors to clearly relay situational occurrences and provide support when needed.
• Identifying and quantifying trends/issues, developing potential solutions, and effectively communicating them to the appropriate members of the management team along with the potential impact.
• Effectively prioritizing and managing outstanding refund requests and overpayments to support contract and legal adherence with all payers including Medicare and Medicaid.
• Identifying and implementing process efficiencies across the department including automation opportunities or workflow enhancement opportunities to reduce manual efforts and improve productivity and overall compliance.
• Recognizing and identifying coding deficiencies and exercising the appropriate action based upon compliance and CMS regulations.
• Identifying key stakeholders or primary contacts within payer communities to drive more effective processes.

Qualifications

• Clear understanding of the intricacies of medical billing encountered in areas like ambulatory care, physician/provider offices, or professional billing settings.
• 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.
• Knowledge of national HIPAA, PHI, and other regulatory requirements to help ensure compliance when working claims data.
• Minimum of 2 years of Medical Billing Experience or health plan claims adjudication experience.

Requirements

• 3-5 Years of Medical Billing experience or health plan claims adjudication experience (preferred).
• Technical Certificate in Medical Billing (preferred).
• Microsoft Office with a focus on Excel, Outlook, and Word (preferred).
• Time management skills.
• The ability to multi-task.
• Athena Practice Management experience (preferred).

Education

• Verifiable High School Diploma or GED required.

Benefits

• Comprehensive and competitive mix of pay and benefits.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.