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Position Summary

CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time Pharmacy Claims Biller. As a Biller, you will ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of the billing and reimbursement team, you will work in a fast paced and team focused environment to ensure timely and accurate billing to insurance providers. Located in the Monroeville Facility, this opportunity also provides free parking. We will support you by offering all the tools and resources you need to be successful in a collaborative team-based environment.

• Hybrid Role
• Shift: Monday-Friday, 8:00AM-4:30PM EST (Flex Start after training)
• Training: First 2-3 weeks of employment.

• Third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer.
• Transmit or submit claims (paper/electronic) to insurance payors and other third parties for reimbursement.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information and therapy changes.
• Maintain supporting and chronological notes that detail action taken to resolve billing edits.
• Maintain patient demographic and insurance information and data collections systems, including all billing reports, work queues, or diversions according to payer and company policy guidelines.
• Research and respond to insurance companies and governmental payors regarding billing issues or related questions by telephone, via the internet, and in writing.
• Contact patients, physician's offices or insurance carriers as needed in order to expedite billing claims.

• 1 year of Healthcare Insurance Billing or related experience.
• Customer service skills with the ability to work in a team environment.
• Experience using Microsoft Office products specifically Excel, Outlook, and Word.
• Must live within a 1-hour commute from Monroeville, PA.

• Insurance billing or collections experience.
• Ability to prioritize daily tasks.
• Customer service in a healthcare environment.
• Experience working in a healthcare reimbursement system.
• Effective customer service skills and experience that shows ability to work in a team environment.
• Working knowledge of medical terminology.
• Attention to detail.
• Effective problem solving and decision-making skills.
• Ability to communicate with clientele in a professional manner; both verbally and written.

• Verifiable High School Diploma or GED required.