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Position Summary
The Data Entry – Billing Claims Representative is responsible for the billing coordination of patients with payors that have unique qualifications and billing requirements for NCPDP related claims and ensuring prescription drug dispenses are adjudicated successfully for payer claim approval prior to delivery of medication without delay in patient care. Medical Billers collaborate with NCPDP Specialists to seek payer override of denied claims and assist pharmacies to plan future shipments that prevent denials.
PRIMARY DUTIES AND RESPONSIBILITIES:
Responsibilities
1. Performs the billing of medications and or services as required for each subsequent dispense as outlined by the payor requirements.
2. Maintains the medical record in ECM with scanning results of each adjudication performed; and in HC360 through progress note entry.
3. Communicates the patient co-payment or patient financial responsibility to dispensing pharmacy.
4. Contacts payers as required in order to resolve rejected NCPDP claims and performs data entry into HC360 as required.
5. Performs data entry to complete the patient registration and adjudication in software application (CE2000).
6. Performs other duties and responsibilities as assigned.
Typical work hours for this position are Monday – Friday, rotating between 10:30 AM – 7:00 PM CST. This is a full-time career that offers excellent Medical, Dental and Vision coverage, a competitive 401k, and additional benefits.
Partner with Coram/CVS Health and you’ll have an exciting opportunity to utilize your healthcare training and customer services skills to provide specialty infusion services administered to patients in their homes. In this role, you will partner with a team who are passionate about making a difference in patient’s lives. You can have an impact by providing the best care, education, and support to our patients, improving their overall quality of life!
Required Qualifications
Minimum one year of experience in medical billing or collections, accounts payable, or accounts receivable.
– Minimum one year of experience working with healthcare reimbursement systems.
– Excellent customer service orientation.
– Attention to details and excellent time management skills.
– Proficiency in Microsoft Office software – Word, Excel, and PowerPoint.
Preferred Qualifications
2+ years experience in medical billing
Education
High School diploma or GED is required
Pay Range
The typical pay range for this role is:
$17.00 – $29.30
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.