Cumberland, Rhode Island

Job Description
The 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
1 or more years of Medical Billing Experience or health plan claims adjudication experience

Preferred Qualifications
2 or more Years of Medical Billing experience or health plan claims adjudication experience
Provider Enrollment experience
Technical Certificate in Medical Billing
Athena Practice Management experience
Experience with Provider Enrollment and credentialing functions

Education
Verifiable High School Diploma or GED required

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. 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. See Job Description

Cumberland, Rhode Island

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses

 

"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."

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