About the Company
CVS Health is a leading healthcare innovation company with a purpose to help people on their path to better health. We provide a full range of pharmacy services, health plans, and clinical programs, reaching millions of Americans every day. Our team is dedicated to making healthcare more accessible and affordable, and we are committed to fostering a diverse and inclusive workplace.
Job Description
We are seeking a detail-oriented and highly organized Pharmacy Billing Associate with a strong focus on insurance and finance to join our team in Rapid City, South Dakota. In this critical role, you will be responsible for ensuring accurate and timely processing of pharmacy claims, managing billing inquiries, and resolving discrepancies with insurance providers. This position requires a solid understanding of medical billing procedures, insurance regulations, and financial reconciliation practices within a pharmacy setting. You will play a vital part in the financial health of our pharmacy operations and directly impact our ability to serve our patients effectively.
Key Responsibilities
- Process and submit pharmacy claims to various insurance carriers (commercial, Medicare, Medicaid, etc.) accurately and efficiently.
- Investigate and resolve denied or rejected claims by collaborating with pharmacists, patients, and insurance companies.
- Monitor accounts receivable for pharmacy claims and follow up on outstanding balances.
- Respond to patient and insurance company billing inquiries in a professional and timely manner.
- Perform financial reconciliations and generate billing reports.
- Maintain up-to-date knowledge of insurance policies, billing codes (e.g., NCPDP), and regulatory changes.
- Assist with patient financial counseling regarding prescription costs and insurance coverage.
- Document all billing activities and patient interactions accurately in the pharmacy management system.
- Collaborate with the pharmacy team to optimize billing processes and ensure compliance.
Required Skills
- Minimum 6 months experience in medical or pharmacy billing.
- Proficiency with pharmacy billing software and electronic health records (EHR) systems.
- Strong understanding of insurance claim submission and denial management.
- Excellent attention to detail and organizational skills.
- Strong analytical and problem-solving abilities.
- Effective written and verbal communication skills.
- Ability to work independently and as part of a team in a fast-paced environment.
Preferred Qualifications
- Associate's degree in Medical Billing, Healthcare Administration, or a related field.
- Pharmacy Technician certification (CPhT).
- Experience with specific CVS Health billing systems.
- Knowledge of HIPAA regulations and patient privacy guidelines.
Perks & Benefits
- Comprehensive health, dental, and vision insurance.
- Paid time off and holidays.
- 401(k) retirement plan with company match.
- Employee assistance program.
- Tuition reimbursement opportunities.
- Career development and growth opportunities within a large healthcare organization.
- Employee discount programs.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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