Medical Billing Specialist, Medicaid

CVS Health - Phoenix, AZ3.5

Full-time
EducationSkillsBenefits
Position Summary:
CVS Health has an exciting opportunity for you to join a growing team at our brand new Phoenix facility as an Accounts Receivable Specialist! You will sit on a dynamic team that supports our Infusion Services patients. This role is in an ever changing, energizing environment that provides you with the opportunity for learning new skills and continuing to grow your career.

In this role, you will support our Accounts Receivable (A/R) Department with various A/R functions for Specialty Infusion. You will handle the completion of Patient Financial Services (PFS) tasks, including patient and payer follow up as needed. The PFS tasks you will complete include billing and/or accounts receivable follow-up while maintaining quality and productivity requirements. You will build and submit accurate and timely claims to payers, as well as research and analyze unpaid claims. You will be assisting in the resolution of denials, partial payments, and payment variances.

In the Accounts Receivable role you will:
  • Maintain and release all-ship-verified claims for all third party claim accounts within established time frame as assigned Resolve errors and make claim edits assigned in work queues
  • Follow work list prioritization of accounts for resolving accounts and/or submitting claims
  • Contact payers and patients when necessary for PFS processes Request relevant information from appropriate
  • Revenue Cycle and clinical departments as required through the course of the PFS processes
  • Make necessary adjustments to patient demographic, insurance, and account balance information
  • Complete A/R adjustments and request other adjustments where permitted and appropriate
  • Adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements), and "leading practices"
Required Qualifications

Minimum of 18 months of experience in the following:
  • Performing healthcare reimbursement, medical insurance billing or collections
  • Working with Microsoft Office, specifically Excel, Outlook and Word
Preferred Qualifications
  • Familiarity with Medicaid or Managed Medicaid
Education
Verifiable High School diploma or GED is required.

Business Overview
Coram CVS/specialty infusion services is a leading national provider of specialty home infusion and specialty pharmacy services. The integration of Coram into CVS Health enables the company to offer enhanced, comprehensive infusion services; expanded payer access; and a national network of more than 85 locations, including 65 ambulatory infusion suites. Providing infusion therapies and services to over 20,000 patients each month, Coram cares for patients through all phases of their healthcare continuum including clinical and compliance monitoring, and individual patient counseling. CVS Health, through our unmatched breadth of service offerings, is the nation’s largest pharmacy health care provider transforming the delivery of health care services in the U.S. Our energetic and service-oriented colleagues embrace fresh ideas, new perspectives, a diversity of experiences, and a dedication to service to meet the needs of the many people and businesses relying on us each day.