Medical Billing Specialist

CVS Health - Phoenix, AZ (30+ days ago)3.5

Become a part of our growing team at our Phoenix facility! As a Medical Billing Specialist for our Infusion Accounts Receivable (A/R) Department, you will be responsible for completing Patient Financial Services (PFS) tasks such as billing and/or accounts receivable follow-up with payers and maintaining quality and productivity requirements as outlined in the position performance expectations. You will process and submit accurate and timely claims to payers,analyze and research unpaid claims, and assist in the resolution of denials, partial payments, and payment variances.

Additional responsibilities of the Medical Billing Specialist include:

  • Maintain and release all-ship-verified claims for all third party claim (commercial or government) accounts within established time frame as assigned
  • Resolve errors and make claim edits assigned in work queues
  • Follow work list prioritization of accounts as established by department policies and procedures 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 where permitted and appropriate; request other adjustments where permitted and appropriate
  • Comply with and adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements), and "leading practices

Required Qualifications
  • 1+ years performing healthcare reimbursement, medical insurance billing or related work
  • 1+ years working with Microsoft Office, specifically Excel, Outlook and Word
Preferred Qualifications
Prior related healthcare Revenue Cycle experience, preferably within Collections and Billing
Knowledge of healthcare billing, collections practices, and/or infusion service
Exceptional communication, customer service skills, and phone etiquette
Familiarity with customer service expectations, computer processing, and medical and billing office terminology

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.