This position is responsible for gathering and entering information related to the payer status of patients from the facility, or from the responsible party.
- Ensure that census paperwork is received from the Nursing facility.
- Ensure that the census is entered into the operating system accurately and is valid coverage.
- Review paperwork and verify completeness and of intake process focusing on payer verification and selection.
- Ensure effective coordination and communication between the local pharmacy and the Central Billing Center.
- Ensure the smooth dissemination of information relative to Revenue Management to the pharmacy/site and Omnicare customers.
- Work Medicaid Pending reports from i-Astral and the operating system to ensure timely application of Medicaid coverage.
- Improve account identification on Medicaid Application Pending (MAP).
- Work and partner with other internal departments to resolve issues.
- Participate in training session or conference calls to further C2W ADT management knowledge
- C2W ADT Workflow grid is cleared daily for all assigned facilities
- Follow all applicable government regulations including HIPAA.
- Participate in projects and/or meeting as designated by management.
- Other duties as assigned; job duties may vary by location.
- Basic knowledge of insurance procedures
- Ability to work in a fast paced, rapidly changing environment.
- Excellent verbal and written communication as well as listening skills.
- Intermediate computer and typing skills.
- Healthcare Industry Experience
- Minimum of 1 – 3 years of experience working in an office/business setting
- Prescription third party claims management experience
- 6 -12 months of long term care pharmacy billing experience.
- High school diploma or equivalent.
It’s a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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